Jan 15, 2009 | Medical billing basics
What is POS The Health Insurance Portability and Accountability Act of 1996 (HIPAA) will become effective October 16, 2003, for all covered entities. Medicare is a covered entity under HIPAA. The final rule, “Health Insurance Reform: Standards for Electronic...
Jan 15, 2009 | Medical billing basics
What should occur when a medical provider’s bill is received by the payer?Workers’ compensation payers must respond to all medical bills. For each medical bill received for which no first report of injury has been issued, the payer must follow up by telephone with the...
Jan 14, 2009 | Medical billing basics
What information must the medical provider include on the UB 92 or CMS 1500 forms submitted to the payer?When submitting medical bills, the provider must include*:Entity’s nameEntity’s tax IDEmployee’s (patient’s) nameEmployee’s (patient’s) phone numberEmployee’s...
Jan 10, 2009 | Medical billing basics
Where is information available for medical providers treating patients with injuries/conditions that may be the subject of a workers’ compensation claim? The North Carolina Industrial Commission website. The Industrial Commission is the state agency responsible for...
Dec 21, 2008 | Medical billing basics
Medicare Remittance Group Code An ANSI Group Code is always shown with each ANSI reason code to indicate when you may or may not, bill a beneficiary for the non-paid balance of the services or equipment you furnished. Group codes are not used with Medicare Reference...
Dec 17, 2008 | Medical billing basics
Detail Fields:Serv Date: This field provides the service from and to dates as well as the patient’s responsibility.POS: The place of service field contains a two digit number that references where the services were rendered.NOS: The number of service field shows...
Nov 18, 2008 | Medical billing basics
How we can submit the secondary claims by electronic Insurance primary to Medicare should be reported in Items 4, 6, 7, 10 (a-c) and 11 (a-c). For electronic claims only, it is imperative the correct two-digit Medicare Secondary Payer (MSP) insurance type code is...
Nov 17, 2008 | Medical billing basics
Claim StatusWait for the 14 day electronic and 29 day paper payment floor before calling-use the IVR systemRemittance AdviceGroup Code meanings to assist providers in reading remittance advices Payment CalculationMedicare payment at 80% of the allowable, minus...
Nov 16, 2008 | Medical billing basics
Denial – Incorrect diagnosis or Required Modifier not billied” As per Medicare newsletters “Incorrect Diagnosis” and “Required Modifier Not Billed” accounted for a large percentage of the provider/supplier billing errors. Lab...
Nov 12, 2008 | Medical billing basics
Patient calling – step by step guide Seven Steps To A Successful Collection Phone Call A successful collector is very much aware of and trained in the following seven steps for a successful collection phone call. Step 1: Identify the person you are calling“...
