Apr 24, 2011 | Medical billing basics
Electronic Signatures Providers using electronic systems need to recognize that there is a potential for misuse or abuse with alternative signature methods. The individual whose name is on the alternative signature method and the provider bear the responsibility for...
Apr 23, 2011 | Medical billing basics
Coordination of Benefits Coordination of benefits (COB) refers to two or more insurance plans covering one individual, coordinating their respective benefits to share the cost of health care. COB rules identify one plan as the primary payer (this plan pays regular...
Apr 22, 2011 | Medical billing basics
Documentation Requirements for CPT Code 99211 The table below contains elements that would constitute adequate documentation of a code 99211 service in selected clinical circumstances: Blood pressure check 1. Blood pressure and other vital signs recorded. 2. Clinical...
Apr 21, 2011 | Medical billing basics
All Other Appeals If an appeal does not fit into any of the three categories listed above, it is considered an appeal type of “Other.” Examples include but are not limited to: • Out-of-network provider requesting additional payment without changing the claim’s...
Apr 20, 2011 | Medical billing basics
CPT code 99211© is used to report a low-level Evaluation and Management (E/M) service. The CPT book defines code 99211 as: “Office or other outpatient visits for the evaluation and management of an established patient, that may not require the presence of a physician....
Apr 19, 2011 | Medical billing basics
The Adverse Determination External Review process will provide for an Independent Review Organization (IRO), to resolve disputes with physicians and physician groups arising from BCBSF’s determination that certain services provided to BCBSF’s members are not covered...
