Oct 2, 2010 | Medical billing basics
Lock-in The Alabama Medicaid Agency closely monitors program usage to identify recipients who may be potentially overusing or misusing Medicaid services and benefits. For those identified recipients, qualified Alabama Medicaid staff performs medical desk reviews to...
Oct 2, 2010 | Medical billing basics
Understanding the Eligibility Response When you use Provider Electronic Solutions software, or AVRS to verify eligibility, the system returns a detailed eligibility response. You will receive confirmation of the information displayed on the recipient’s plastic card,...
Oct 2, 2010 | Medical billing basics
The Medicare Claims Processing Manual (Chapter 12, Section 30.6.7) now defines “new patient” for the E/M visit code and reads as follows. Interpret the phrase “new patient” to mean a patient who has not received any professional services, i.e., evaluation and...
Oct 2, 2010 | Medical billing basics
I am a physician who needs to have an enrollment record in PECOS. What do I do? You can submit your enrollment application in one of two ways: (1) Use Internet-based PECOS · Step 1. Before you begin, be sure you have a National Provider Identifier (NPI) and have...
Oct 2, 2010 | Medical billing basics
When is an NPI entered in block 32 and how do I share my NPI with Medicare? Medicare does not require an NPI in block 32a nor a legacy number in 32b. If you are using the new CMS-1500 version 08-05, and if you previously populated boxes 17a (referring provider), 24j...
Oct 2, 2010 | Medical billing basics
PI and NPPES User Name and Password Information Q: Who do I contact if I cannot remember my NPPES password? A: Contact the NPI Enumerator at 1-800-465-3203 or send an e-mail to customerservice@npienumerator.com. Q: How do I change my NPPES password? A: Go to...
