May 18, 2011 | Medical billing basics
DESCRIPTION OF THE ISSUEThe Medicaid claims statuses states; the pay to provider is not eligible for direct payment. CONCEPTAny carrier should possess EFT enhancement during enrollment process inorder to obtain any claim status during verification. SOLUTIONUpon...
May 16, 2011 | Medical billing basics
DESCRIPTION OF THE ISSUEPTAN# was not issued for Dr. . Hence all the RR MCR claims were in pending for long duration. CONCEPTRRMCR requests for appropriate PTAN# for processing its claims. SOLUTIONAfter regular follow-ups with the Insurance on request to issue...
May 13, 2011 | Medical billing basics
DESCRIPTION OF THE ISSUEThe claims of Wellcare were initially denied for “No Authorization on file”. {submitted with the Tax-Id# 123456789}. CONCEPTIf a provider is capitated under a plan, we need to verify on all the information of the provider with the concerned...
May 11, 2011 | Medical billing basics
DESCRIPTION OF THE ISSUEWe received denials for the CPT 81001 as “Provider is not certified eligible to perform this procedure” – CPT 81001 (Urinalysis with microscope) CONCEPTAny provider should be aware of his eligibility of the services to be performed for...
May 9, 2011 | Medical billing basics
DESCRIPTION OF THE ISSUEPreviously we had billed Hospice covered patient claims to Medicare with GW modifier to get quicker payments. Balance of 20% coinsurance was billed towards patients. Client raised an issue to file the claims to the concerned Hospice care itself...
