Nov 7, 2015 | Medical billing basics
Q: What is the difference between the effective date and retrospective billing date? A: The effective date is the later of the following two dates: • The filing date of an enrollment application that was subsequently approved, or • The date the provider first began...
Nov 6, 2015 | Medical billing basics
1. All documentation must be maintained in the patient’s medical record and available to the contractor upon request. 2. Every page of the record must be legible and include appropriate patient identification information...
Oct 31, 2015 | Medical billing basics
A. Yes. When you receive an overpayment demand letter indicating a refund is due, you can request immediate offset of the debt in writing. The immediate recoupment process allows providers to request that recoupment begin prior to day 41. Providers who elect this...
Oct 27, 2015 | Medical billing basics
Bariatic Surgical Management of Mobid Obesity Coding Information 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...
Oct 23, 2015 | Medical billing basics
Self-Referral Services Self-referral services are defined in the HealthChoice regulations as “health care services for which under specified circumstances the MCO is required to pay without any requirement of referral or authorization by the primary care provider...
Oct 19, 2015 | Medical billing basics
Claim and encounter addresses To decrease administrative costs and improve cash flow, clinicians and facilities are encouraged to use electronic claim submission whenever possible. When it is necessary to submit paper claims, you can use the addresses below. Please...
