Dec 26, 2013 | Medical billing basics
Change of Ownership When an organization having a provider agreement undergoes a change of ownership in accordance with the principles articulated in 42 CFR Part 489 and §3210 of the State Operations Manual, the agreement with the existing provider is...
Dec 14, 2013 | Medical billing basics
Medicare E/M claims for new patients As previously announced with MM8165, Medicare implemented a common working file system edit to identify claims where more than one new patient visit was billed for the same patient within three years. Medicare...
Dec 7, 2013 | Medical billing basics
Yes. Effective October 1, 2012, First Coast Service Options Inc. (First Coast) implemented the PWK (paperwork) segment of the X12N version 5010. PWK allows for voluntary submission of supporting documentation with a 5010 version electronic claim. PWK is a segment...
Nov 29, 2013 | Medical billing basics
Claims From Medicare Advantage Organizations Federal regulations require that Medicare fee-for-service contractors maintain payment responsibility for managed care enrollees who elect hospice. These regulations are found that Medicare Fee for Service retains payment...
Nov 24, 2013 | Medical billing basics
Vaccines for Recipients Birth through (18) Years For eligible recipients from birth through (18) years of age, vaccines and combination vaccines providing protection against the following diseases are available free to the VFC-enrolled provider through the VFC...
Nov 18, 2013 | Medical billing basics
Child Health Check-Up (CHCUP) is available to every Medicaid-eligible child under age (21). It includes screening (or well-child check-ups), diagnosis and treatment. To provide Child Health Check-Ups, a provider must be enrolled in Medicaid as a provider with a...
