Oct 24, 2009 | Medical billing basics
Knowing about denial EOB is very importance process in Medical billing. See the example denial EOB picture.We need to look the adjustment code and remark code to find denial reason. And go to the summary part see the explanation of the denial and take the action...
Oct 24, 2009 | Medical billing basics
EDI Defined Short for Electronic Data Interchange, “ EDI ” is the transfer of data between companies by use of a computer network. Electronic data transfers are called “ transactions. ” Different transactions have unique functions in...
Oct 24, 2009 | Medical billing basics
Authorization Providers are responsible for verifying recipient eligibility and authorization requirements before providing services/products (the Authorization Department does not handle recipient eligibility inquiries.) Common services that require authorization...
Oct 23, 2009 | Medical billing basics
You may bill recipients only in the following situations: The recipient’s Medicaid eligibility status is pending . If you bill the recipient and they are found eligible for Medicaid with a retroactive date that includes the date of service, you must return the...
Oct 22, 2009 | Medical billing basics
Services Not Included in the Global Package of Major Surgeries These services may be paid for separately. In some instances, you must use the appropriate modifier when billing for these services. 1. The initial consultation or evaluation of the problem by the surgeon...
Oct 21, 2009 | Medical billing basics
Medicare advantage plans Medicare claim submission address Medicare plan or Part D Helath insurance claim denial codes Medicare timely filing limit Medicare hospice denials Anesthesia medical billing guidelines Medical billing basics Medical billing AR Medical billing...
Oct 21, 2009 | Medical billing basics
What is HIPAA compliance The Health Insurance Portability and Accountability Act of 1996 (HIPAA – Public Law 104-191) gives individuals certain rights concerning their health information, sets boundaries on how it is used, establishes formal safeguards and holds...
Oct 21, 2009 | Medical billing basics
Determining the Duration of a Global Period To determine the global period for major surgeries, count 1 day immediately before the day of the surgery, the day of surgery and the 90 days immediately following the day of surgery. For example, if the date of surgery is...
Oct 20, 2009 | Medical billing basics
Surgical Modifiers Global Surgery Surgeons have traditionally provided a “ Global Package ” of care. Under this concept , surgeons bill a single fee for all services usually associated with the surgery. The implementation of the Medicare fee schedule under physician...
Oct 15, 2009 | Medical billing basics
Ambulatory Surgery Centers (ASC) modifier SG Every ASC must file using the surgery code with the SG modifier. This identifies you are filing for the facility fee. If you file without the SG modi fier you may receive the fee schedule amount for the surgery instead of...
