AR person role and responsibilty – Reports

Reports.This is a very good weapon for an AR person to have since it helps him to run reports restricting for a particular carrier, procedure or Insurance. In this way he can be able to pinpoint if the same problem is covering a wide range of accounts, then with just...

Medicaid EOB and denial reason codes

Handling Medicaid or Medical (CA) denials, its very difficult in Medical billing since most of the time their denial reason is very difficult to understand. Here i have given the example of Medicaid EOB. Double click it to see the full image. We will see the...

AR person role and responsibilty – Part 3

Modifier.Modifiers provide the coder with a means to indicate that a service or procedure that was performed has been altered by some specific circumstance but not changed in its definition. The proper use of modifiers reduces the need for separate procedure listings...

BCBS EOB and denial codes – Part 2

BCPR Copayment is required.This amount has to be paid by patient. Bill the patient. PNMAP This amount represents BCBSFL’s maximum allowable amount. D0706 NO record of Membership Check your patient name and id card and rebill. D1083 – Home plan denied wrong...

AR person Role and Responsibility – Part 2

Charge Entry.Here once again the AR person need not know exactly how charges are being entered, but he should have a working knowledge of how it is being done. For example should the carrier ask the AR rep what modifier was used? Then he should be able to figure out...
BCBS EOB and Denial Codes

BCBS EOB and Denial Codes

We will see each and every denial codes in a detailed fashion in next post. Sample BCBS EOB and Denial Codes  BCPR Copayment is required.This amount has to be paid by patient. Bill the patient. PNMAP This amount represents BCBSFL’s maximum allowable amount....

AR Person role and responsibilty – PART 1

Patient Doctor ConsultationThis is a situation wherein a patient goes to see a specialist the doctor then reviews the patients past history records, as well as run a series of tests to identify the exact problem. On this a treatment chart would be created so that the...

AR person role and responsibility

Issues that the AR person needs to be aware off. Patient Doctor consultation. Information obtained at the front desk (Center Co-ordination) Scanning Filing System of Documents Numbering system for entering accounts in the system Charge Entry Cash Posting...

Denial and Actions – CO B16

CO B16Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice. (DENIED-RENDERING PHYSICIAN #INVALID/MISSING. SUBMIT A NEW CLAIM)(DENIED-CLIA NUMBER INVALID OR MISSING.) This denial comes see the NPI...