May 8, 2011 | Medical billing basics
DESCRIPTION OF THE ISSUESecondary Medicaid denied claims as Medicare coverage is present/ Crossover data missing at detail level. As per our conversation with Medicaid they do not cover the balance left from Primary Medicare HMOs. CONCEPTIf patient have Medicare HMO...
May 6, 2011 | Medical billing basics
DESCRIPTION OF THE ISSUEWhenever we use Psychiatric related diagnosis as primary one on a claim, this will cause a payment reduction from Medicare. The reduction has covered by some of the commercial secondary Insurances and if the patient does not have such, we could...
May 4, 2011 | Medical billing basics
DESCRIPTION OF THE ISSUE All the claims under Orlando Health care are awaiting for W9 form from the provider. CONCEPT Carriers request on any information should be submitted for the claims to be reimbursed. REASON Upon several submission of W9 form of the provider...
May 2, 2011 | Medical billing basics
DESCRIPTION OF THE ISSUEAdvantra was undertaken by Coventry beginning of 2010. This was not noticed and the forwarded claims of Advantra were in pending for long duration. Upon notification and filing of claims towards Coventry resulted in TFL denials....
May 1, 2011 | Medical billing basics
DESCRIPTION OF THE ISSUESelf-pay uncollected balances were not directly moved towards Collection Agency. We made an analysis from our end to find reason for unpaid balances and came with appropriate solutions to gain payments to the provider. CONCEPTUnpaid...
