Dec 21, 2010 | Medical billing basics
Please note: The Blue Shield Drug Database & Formulary has been updated to reflect the changes from the December 2010 Pharmacy and Therapeutics (P&T) Committee meeting. Drugs Added to the Formulary: Exelon Patch Exelon Oral Solution Vyvanse Drugs Removed from...
Dec 21, 2010 | Medical billing basics
blueshieldca – Medication Policy Update Medication Coverage Policy Updates Please note: As a result of the December 2010 Pharmacy and Therapeutics (P&T) Committee meeting, Blue Shield of California is announcing updates to some medication coverage...
Dec 18, 2010 | Medical billing basics
OUTPATIENT HOSPITAL Is a pre-certification required from Health Care Excel (HCE) for outpatient services and/or surgical procedures? No, a pre-certification from HCE is not required for outpatient services and/or surgeries. If a hospital has an outpatient claim that...
Dec 16, 2010 | Medical billing basics
Unconfirmed Diagnosis When a provider is not certain of a diagnosis, capture the known manifestations, signs, symptoms, or abnormal test results. Example: The diagnosis documented, as “rule out malignant neoplasm of the pancreas” cannot be coded, as the...
Dec 15, 2010 | Medical billing basics
Reimbursement will vary from state state. The following factors are will determine the cost. CMS has approved cost allocation plans from States which include the following types of administrative costs necessary for the proper and efficient administration of the State...
