Sep 22, 2009 | Medical billing basics
Denial code co – 45 – Charges exceed your contracted/legislated fee arrangement. Note: This adjustment amount cannot equal the total service or claim charge amount; and must not duplicate provider adjustment amounts (payments and contractual...
Sep 21, 2009 | Medical billing basics
Medicare as a Secondary Payer (MSP) 1.Medicare can be secondary to another insurance plan in the following cases: 2. Patient is above 65 and is still working and is covered by an Employer Group Health Plan (EGHP) or spouse who is above 65 is employed with coverage by...
Sep 21, 2009 | Medical billing basics
What is place of Service Place of Service denotes the place where the service was rendered within the facility. For e.g. the patient may be an inpatient or an outpatient or in an emergency room or in an ambulatory surgical center. Certain carriers adopt...
Sep 15, 2009 | Medical billing basics
Which clearing house is best We have conducted a poll for the above title and the result is. We could not consider this 100% accurate since the number of user get participated in the poll is very less. And i personally feel that the number one positiioned clearing...
Sep 13, 2009 | Medical billing basics
We need to get the below information wilie calling insurance for insurance verification. INSURANCE VERFICATION: 1.Effective date 2.Patient policy status as of current date either Active or Inactive 3.Type of Plan like PPO, HMO, POS etc… 4.Copay- 5.Deductible amount...
Sep 7, 2009 | Medical billing basics
What is A Modifier? Modifiers are two digit codes used to report additional information used during claims processing. Modifiers may be alpha-alpha, alpha-numeric or numeric -numeric, such as AA, E1 or 25. Some modifiers describe additional work or circumstances that...
Sep 7, 2009 | Medical billing basics
Sometimes patient enrolled in Managed care plan or HMO in order to receive more benefits and for low premium or low copays. If the patient is working after 65 years then the employer provide the EGHP plan to cover the employee medical expenses. In the above case...
Sep 7, 2009 | Medical billing basics
WHAT IS MEDICAL BILLING? Every health care provider that delivers a service receives money for these services. While most of them prefer to collect payment from patients at each office visit, the majority of their fees are processed by filing a claim with the...
Sep 5, 2009 | Medical billing basics
The physician does not get paid for his services immediately after they are rendered. Majority of the patients have insurance coverage and details of such coverage are provided to the physician before treatment. It is the responsibility of the physician to submit...
Sep 2, 2009 | Medical billing basics
Medicla billing abbreviations – Updated list EOB – Explanation of benefits COB -Co-ordination of Benefits MSP – Medicare as a Secondary Payer POS – Place of service TOS – Type of Service DOS – Date of service ICD – 9...
