Feb 21, 2014 | Medical billing basics
000 ERROR: Provider’s specialty code What this means: The rendering provider information is either incomplete or missing from the EDI system, or it doesn’t match what is being sent on the claim. Provider action: Check the rendering...
Feb 12, 2014 | Medical billing basics
Exact duplicate claim/service (DUPLICATE CHARGE PAID ?002XX ON CLAIM ?001XXXXXXXXX) (DUPLICATE CHARGE OF CLAIM ?001XXXXXXXXX NOW BEING PROCESSED) (THIS IS A DUPLICATE OF A CHARGE WE HAVE PROCESSED) (MORE THAN 1 E/M SERVICE BILLED ON THE SAME DAY) Resources/tips for...
Feb 3, 2014 | Medical billing basics
Customer service representatives cannot provide claim status via the toll-free service line Medicare guidelines, specifically, the Internet-only manual (IOM) Publication, 100-09 Chapter 6 Section 50.1 requires that providers call the interactive voice response system...
Jan 13, 2014 | Medical billing basics
As a general rule, where the contractor receives a late filed claim submitted by a provider or supplier with no explanation attached as to the circumstances surrounding the late filing, the contractor should assume that the provider or supplier accepts responsibility...
Jan 8, 2014 | Medical billing basics
Determining End Date of Timely Filing Period—Receipt Date A submission, as defined above, is considered to be a filed claim for purposes of determining timely filing on the date that the submission is received by the appropriate Medicare claims processing...
Dec 31, 2013 | Medical billing basics
Common Working File (CWF) Informational Unsolicited Response (IUR) or Reject for a New Patient Visit Billed by the Same Physician or Physician Group within the Past Three Years Note: This article was revised on June 4, 2013, to reflect the revised CR8165 issued on May...
