Jan 23, 2016 | Medical billing basics
1.0 Standardized Billing / Electronic Billing Definitions; (a) “Assignee” means a person or entity that has purchased the right to payments for medical goods or services from the health care provider or health care facility and is authorized by law to collect payment...
Jan 22, 2016 | Medical billing basics
Errors That Result In Denied Claims; This information is presented for you to review your internal procedures and identify areas where the number of denied claims could be reduced. Denied claims result in delay of payment. Please note HIPAA claim adjustment reason and...
Jan 12, 2016 | Medical billing basics
New and revised place of service codes for outpatient hospitals Note: This article was revised December 9, 2015, to clarify the effective date of place of service (POS) 19. POS 19 will be accepted for any claims processed on or after January 1, 2016. That is, POS code...
Jan 8, 2016 | Medical billing basics
ABN modifiers When a patient is notified in advance that a service or item may be denied as not medically necessary, the provider must annotate this information on the claim (for both paper and electronic claims) by reporting modifier GA (waiver of liability statement...
Dec 23, 2015 | Medical billing basics
Bill Type Codes Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types...
Dec 13, 2015 | Medical billing basics
Interactive voice response (IVR) system capabilities The IVR system provides automated information on claims, benefits and more, 24 hours a day, seven days a week. Call the number on the back of the member’s Humana identification card to reach the IVR system....
