Sep 20, 2008 | Medical billing basics
Action – Denied as CLIA (Clinical Laboratory Improvement Act ) no missing MRA reason code CO-B7: This provider was not certified/eligible to be paid for this procedure/service on this date of service. MRA reason code CO-16: Claim lacks information which is...
Sep 19, 2008 | Medical billing basics
Action – Provider not eligible for this service MRA reason code CO-B7: This provider was not certified/eligible to be paid for this procedure/service on this date of service. MRA reason code CO-38: Services not provided or authorized by designated...
Sep 17, 2008 | Medical billing basics
Action – Denied as Medicare Secondary Payer (MSP) MRA reason code PR-22: This care may be covered by another payer per coordination of benefits. Resolution · Patient screening is an excellent way for providers to obtain valuable information necessary for proper...
Sep 15, 2008 | Medical billing basics
The action – Denied as Non covered service MRA reason code PR-96: Non-covered charge(s). · Remark message N115: This decision is based on an LMRP or LCD. An LMRP/LCD provides a guide to assist in determining whether a particular item or service is covered. MRA...
Sep 12, 2008 | Medical billing basics
Denial reason 6. Bundled Services MRA reason code CO-125: Submission/billing error(s) (National Correct Coding Initiative (NCCI)). · Remark message M15: Separately billed services/tests have been bundled as they are considered components of the same procedure....
Sep 7, 2008 | Medical billing basics
CMS 1500 – BLOCK 24A DATES OF SERVICE Enter the six or eight – digit date (MMDDYY) (MMDDCCYY) for each procedure, service, or supply. When “from” and “to” dates are shown for a series of identical services, enter the number of days...
Sep 4, 2008 | Medical billing basics
CMS 1500 – BLOCK 12 PATIENT OR AUTHORIZED PERSON’S SIGNATURE The patient or an authorized representative must sign and enter the six – digit date (MMDDYY) for this block unless the signature is on file. In lieu of signing the claim, the patient may...
Aug 27, 2008 | Medical billing basics
HCFA BOX BLOCK 9 OTHER INSURED’S NAME Enter the last name, first name, and middle initial of the enrollee in a Medigap policy, if it is different from that shown in block 2. Otherwise, enter the word “SAME”. If no Medigap benefits are assigned, leave...
Aug 25, 2008 | Medical billing basics
CMS-1500 Complete reviewClaim FormThe upper right margin of the claim form should not be used. This area of the claim form is used by the carrier. Any obstructions in this area will hinder timely and accurate processing of claims. The top right margin of the claim...
Aug 22, 2008 | Medical billing basics
Reports has to be maintained on a daily basisAfter the daily routine of demographics, charge entry, claims processing etc are done, the accounting day is closed. This is a process wherein you are closing a particular day and opening the next day for data entry. After...
