Oct 22, 2010 | Medical billing basics
Limitations on Services Within each calendar year each recipient is limited to no more than a total of 14 physician visits in offices, hospital outpatient settings, nursing facilities, rural health clinics or Federally Qualified Health Centers. Visits not counted...
Oct 19, 2010 | Medical billing basics
Cost Sharing (Copayment) The copayment amount for physician office visit (including crossovers, and optometric) is $1.00 per visit. Copayment does not apply to services provided for pregnant women, nursing facility residents, recipients less than 18 years of age,...
Oct 19, 2010 | Medical billing basics
PCP Office Lab List – covered list 81000 – Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with...
Oct 19, 2010 | Medical billing basics
What is a taxonomy code? ANSWER: The Healthcare Provider Taxonomy Codes are a HIPAA standard code set named in the implementation specifications for some standard HIPAA transactions. Originally intended to designate specialty, there has been no validation of these...
Oct 18, 2010 | Medical billing basics
How long will it take to get an NPI? We cannot predict the amount of time it will take to obtain a National Provider Identifier (NPI) because several factors come into play. Such factors include the volume of applications being processed at a given time, whether the...
Oct 16, 2010 | Medical billing basics
Electronic claims may be submitted using a variety of methods: • Provider Electronic Solutions software, provided at no charge to Alabama Medicaid providers • Value Added Networks (VANs) or billing services on behalf of an Alabama Medicaid provider • Tapes or other...
