May 13, 2016 | Medical billing basics
Filing the Medicare Cross-Over Claim File the claim to your Medicare carrier for primary payment. Claim information will not be crossed over to the member’s supplement plan (the secondary payer) until after Medicare has processed the claim and released it from the...
May 10, 2016 | Medical billing basics
Q: My claim rejected, or was returned to provider, as a duplicate of another claim. Can I resubmit the claim? What steps can I take to avoid duplicate claims? A: Claim system edits are in place to detect duplicate services. The edits search within paid, finalized,...
May 6, 2016 | Medical billing basics
Electronic Bill Attachments (a) Required reports and/or supporting documentation to support a bill as defined in Complete Bill Section 3.0 shall be submitted in accordance with this section. Unless otherwise agreed by the parties, all attachments to support an...
Apr 30, 2016 | Medical billing basics
Procedure Modifier and Diagnosis Codes A critical element in claims filing is the submission of current and accurate codes to reflect the services provided. Correct coding is essential for correct reimbursement. Inclusion of a complete and accurate list of diagnosis...
Apr 20, 2016 | Medical billing basics
My inpatient claim is overlapping a home health episode with the same date(s) of service. How can I resolve this? A: Claims for inpatient hospital and skilled nursing facility (SNF) services have priority over claims for home health services, as beneficiaries cannot...
Apr 20, 2016 | Medical billing basics
The Centers for Medicare & Medicaid Services (CMS) will implement Change Request (CR) 9252 on January 4, 2016, effective October 1, 2015. (See related MLN Matters® article MM9252.) This CR establishes the list of covered conditions and corresponding...
