Billing Medicare Secondary Payor ClaimsBilling Medicare Secondary Payor ClaimsMedicare Secondary Payor forms can be filled out at the time of service in the case that Medicare doesn't have the SCD Secondary Claim Development Questionnaire form. Learn to get paid when Medicare doesn't have one on file 
Articles
How to complete MSP paper claims?
2008-04-09 19:09:00 If your office is still dropping secondary paper claims to Medicare you will want to make sure you are sending them complete documentation.1. A CMS - 1500 claim form2. A legible copy of the primary Explanation of Benefits (EOB). Do not highlight anything on the EOB and do not put the primary insurer paid amount in fiel 29 of the claim form.EOB should indicate the billed amountEOB should indicate the allowed amountEOB should indicate the paid amountEOB should indicate if you are in network or out of network with the primary insurance carrier3. If the claim was denied by the primary insurer, the remark code explanation for the denial must be included with documentation. If these remark codes are on the last page of the EOB or on the back of the EOB you will need to submit this information on a seperate page.Medicare OCR scanners do not copy the front and back of the EOB's so it's possible that you may need to submit 3 pages of documentation to Medicare.For those of you tired of drop... More About: Paper , Claims , Complete
Anyone using CollaborateMD?
2008-04-04 05:50:00 I would like to talk with anyone who has used or is currently using CollaborateMD medical billing software ? I am interested in learning more about the user features and the pro's and con's. I have thoroughly looked at the CollaborateMD website and it seems like it can cost less going through their per provider per service/inquiry pricing then the standard flat fee of $369 a month per provider from other web-based medical billing software vendors.Curious what others think:http://medicalbillingsoftwarepro.co m/CollaborateMD.htmlhttp://medicalbilling softwarepro.com/Medical-Billing-Software- Reviews.html
How to export your data from Medisoft?
2008-04-01 19:55:00 Have you ever needed to export your data from Medisoft but not quite sure how to do it? I found this website which goes through all of the steps...http://tophatmonkey.com/MediExpor t/some additional recommendations:Shorten the demographics tabPrior to exporting the data re-index your data base for the most current information More About: Data , Export
Dermabrasion ICD-9 codes approved by Aetna
2008-03-26 23:39:00 Aetna health insurance will pay out on Dermabrasion procedure codes 15780, 15781, 15782, 15783 when the correct ICD-9 codes are used which are:173.0-173.9 Basal cell carcinoma702.0 Actinic KeratosisICD codes not covered for indications listed in the CPB706.0 Acne Varioliformis706.1 Other Acne709.00 - 709.09 Dsychromia709.2 Scar conditions and fibrosis of skinWhen billing Aetna medical claims in the billing office make sure that you code your claims correctly based on Aetna's requirements. More About: Codes
4 Diagnosis Codes to use when billing Procedure 10040 to Aetna
2008-03-26 23:34:00 If your medical providers office is credentialed with Aetna health insurance and you bill Procedure Code 10040 for Acne Surgery to Aetna health insurance make sure to use the proper ICD-9 codes.659.3 Rosacea (acute)706.0 Acne Varioliformis706.1 Other Acne706.2 Sebaceous Cyst (due to acne)Correctly billing claims to your Aetna medical health insurance is important for correct processing of claims. At this time these are the only 4 ICD-9 codes Aetna health insurance will pay when billed with this procedure code. More About: Billing , Diagnosis , Codes
Scanners in Medical Offices
2008-03-26 17:08:00 Starting a Medical Biling Service from home takes a lot of strength from anyone. You can't leave your work at the office your home is the office. But what I have found is that working from home can be as comfortable as working in the office when you have the right products to complete your work.One item that I have absolutely enjoyed is my Fugitsu ScanSnap S510 scanner. It has saved me so many times when I needed to email clients documents within minutes. I scribble on my paper, scan it or duplex it, PDF it and shoot it on it's way. The software is so smart it can tell if it needs to kick out "blank" pages. It really has been a benefit to my company and we have one at every computer in our home office (which is currently 2). We have them in each one of our doctors offices where they scan and upload the documents to the billing software (HIPPA compliant) and they love how quickly it completes the scans. You can scan legal paper, regular paper or even Insurance cards.You don't need... More About: Scanners , Offices
Submit claims from RelayHealth to Office Ally
2008-03-24 20:30:00 All customers currently using RelayHealth for electronic claims have an additional option to forward on to Office Ally using CPID# 4264. When submitting claims electronically through RelayHealth they will identify all claims using the 4264 CPID# and forward on to Office Ally for processing.To set this up you will log into your software, pull up your insurance carrier, enter the CPID# 4264 in the correct place and save your changes. When you submit this carrier to RelayHealth they will understand that CPID# 4264 needs to be forwarded on to Office Ally clearinghouse. In order for Office Ally to correctly forward your claim on to the correct health insurance carrier they require the proper payor name be added to the the claim in Loop 2010BB NM103. If you do not have the carriers name entered correctly or they can not identify who the claim should be forwarded on to it will cause a denial. More About: Submit , Claims
How to register for NPI or update your NPI data
2008-03-24 17:32:00 All new medical doctors or providers are required to have a National Provider Identifier (NPI) number. You do not need to be credentialed with Medicare (meaning you do not need to accept assignment with Medicare) in order to register for the NPI number.It takes approximately 20 minutes to apply for a NPI number and it can be completed online or by paper.I have attached a short video under two minutes showing you the steps of how to apply for your NPI number online. https://nppes.cms.hhs.gov/ More About: Data , Update , Register
Clearinghouses are still Stripping information from Medicare Claims
2008-03-24 17:16:00 Medicare has made an announcement to let customers know that they have identified that medical clearinghouses are still stripping information from Medicare claims which could be resulting in claim denials for customers.Medicare would like to let customers know that if they have identified any clearinghouse that is stripping the NPI number from the claim to notify your Medicare Contractor immediately so CMS can work with your clearinghouse to resolve this issue.To verify if this is happening follow these steps:identify that you are sending your NPI # in the correct fields and bill Medicare claims electronically. Call your medical billing software vendor to verify the NPI # is being forwarded on to your clearinghouse (they should be able to track how your eClaims are being submitted)Place a call with your clearinghouse and have them pull your claim file. Have them verify the NPI#'s are on the claim and they are receiving itCall Medicare a few days later and identify if Medicare recei... More About: Information , Medicare , Stripping
NPPES and NPI Registry cross walk to Medicare rejections
2008-03-24 17:02:00 NPPES stands for National Plan and Provider Enumeration System. NPI Registry is a online website to identify referring provider NPPES information including NPI number. All information found on the NPI registry website is provided in accordance with the NPPES Data Dissemination Notice. As of March 1st 2008 all CMS 1500 claims received must hand an NPI or NPI/Legacy pair in the required primary provider fields. If these are not setup correctly the claims will be rejected by Medicare .If your claim is rejected these are some simple rules to follow to identify how to fix those rejections:1. Check your record in the National Plan and Provider Enumeration System (NPPES)2. Verify the Legacy number you are submitting on claims is also reported through the NPPES system.3. Verify that the legal business name is correct4. Verify the correct ENTITY type was selected at the time of NPI Application. Entity Type 1 is for individualsEntity Type 2 is for OrganizationsIf you have verfiied everything a... More About: Cross , Walk
Blue Shield of Illinois requires NPI in all provider loops
2008-03-24 16:52:00 As of March 28th 2008 Blue Shield of Illinois is requiring the NPI number to be sent on eClaims in all provider loops. If the provider does not submit electronic claims with this NPI format you may get the following claim rejections:Exclusion ExamplesHU 0019C:INVALID BILLING PROVIDER ID QUAL - IN LOOP 2010AA, NM108 MUST BE EQUAL TO XXHU 0020C:INVALID PAY-TO PROVIDER ID QUAL - IN LOOP 2010AB, NM108 MUST BE EQUAL TO XXHU 0021C:INVALID CLAIM REF PROV ID QUAL - IN LOOP 2310A(PROF), NM108 MUST BE EQUAL TO XXHU 0022C:INVALID CLAIM REND PRV ID QUAL - IN LOOP 2310B(PROF)/2310C(INST), NM108 MUST BE EQUAL TO XXHU 0023C:INVALID CLAIM PUR SRV ID QUAL - IN LOOP 2310C(PROF), NM108 MUST BE EQUAL TO XXHU 0024C:INVALID CLAIM SRV FAC ID QUAL - IN LOOP 2310D(PROF)/2310E(INST), NM108 MUST BE EQUAL TO XXHU 0025C:INVALID CLAIM SUP PROV ID QUAL - IN LOOP 2310E(PROF), NM108 MUST BE EQUAL TO XXHU 0026C:INVALID CLAIM ATTEND PHY ID QUAL - IN LOOP 2310A(INST), NM108 MUST BE EQUAL TO XXHU 0027C:INVALID CLAIM ... More About: Loops , Provider
Medicare Professional Claims must have NPI
2008-03-24 16:45:00 Effective March 1st 2008, Medicare professional claim subsmission, must have an NPI or NPI Legacy pair in the required primary provider fields. Failure to include an NPI will cause the claim to reject. More About: Claims , Professional
Ohio Medicare remittance issues
2008-03-24 16:27:00 On March 3rd 2008 Ohio Medicare (relay health CPID# 1447) released a new system upgrade. They later identified a bug in the system upgrade resulting in Ohio Medicare deleting provider numbers. This resulted in electronic remittance advice reports not generating.Customers billing Ohio Medicare receiving ERA through McKesson/RelayHealth should post payments manually using the Explanation of Benefits or utilizing the IVR system to identify how claims were processed.Ohio Medicare anticipates having the provider numbers loaded into their system by end of day on March 20th 2008. ERA reports will be available from RelayHealth on March 24th 2008.If you need assistance to work the Medicare Ohio's IVR software please review this blog:All 50 states IVR phone numbers for Part A and Part Bhttp://askamedicalbiller.blogspot.com/20 08/03/medicare-interactive-voice-response -ivr.htmlSteps on how to use the IVR softwarehttp://askamedicalbiller.blogspot .com/2008/03/how-to-use-medicares-interac tive-voic... More About: Issues
Benefits of Using Relay Health for eClaims
2008-03-24 16:15:00 I have been a client of Relay Health for over 3 years and I am exceptionally happy with their services and customer support. The phone calls are answered within 10-15 seconds of calling and the support tech can usually answer my question over the phone. If it can't be answered they log a case and the follow through is amazing. Some of the other benefits of using Relay Health is1600+ electronic claim connections (Medicare, Medicaid, UHC, Cigna, Blue Cross/Blue Shied)450+ electronic remittance connectionsPayor specific edits performed at the clearinghouseCollection LetterseStatementsComplete your eClaim and ERA agreements (for carriers that require this like Medicare/Medicaid) online through McKesson's registration tools. These tools actually scrub your agreement to verify it was completed correctly.RelayHealth is a great company to work with so if you are looking for a new clearinghouse check them out. More About: Benefits
Procedure Code 86580 billed with 90471 or 90472
2008-03-21 19:10:00 As a medical biller I find that my job allows for some interesting insight into how different medical offices bill their services and I always seem to stumble upon "gold" nuggets. In this Medical Billing Example I am comparing two Pediatricians Medical Office in where the providers bill for a 86580 TB Intradermal Test: 1 Medical providers office includes a charge for 90471 Immunization Administrative code 1 Medical providers office bills for just the 86580 (no admin code attached)Many coders would tell you (rightfully so) that a Doctor should not bill a 90471 for administrating the 86580 code. But are you curious to know what I found out on the office that includes a 90471? The medical office that bills for 90471 with use of 86580 in all situations received full payment for the 90471 . The medical office performed this code over 50x's a year. When you take the high's on the allowables for insurance carriers:90471 around $20-25 90472 $8-13& we will say we billed 25 patients wi... More About: Code
Proper use of procedure code 99354 Prolonged Service
2008-03-21 18:34:00 Here is a common Pediatricians office sample using Procedure Code 99354 Prolonged Physician Service with Direct Face to Face Patient Contact.In this situation the patient was having breathing issues and came to the office for treatment. The provider documented that the patient was in the office for 40 minutes and had signs of wheezing and breathing issues. The provider remained in the room with the patient for 32 minutes during the office visit. 99214 - Office or outpatient E&M code 25 minutes face to face with patient and/or familycharge amount for 99214 $190.44 Allowed Amount by pts ins $126.2899354 - Prolonged Office visit 30+ minutes face to facecharge amount for 99354 $200.00 Allowed Amount by pts ins $127.8694640 - Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposescharge amount for 94640 $64.32Allowed Amount by pts ins $0.00 J7603 - Albuterolcharge amount for J7603 $40.00Allowed Amount by pts ins ...
CPT Category 1 Codes by Section
2008-03-21 17:23:00 Grouping of codes assist with finding the procedure code needed quickly. This is a to the point tutorial on the grouping of the CPT Category 1 Codes :99201-99499 Evaluation and Management00100-01999, 99100-99140 Anesthesiology10021-69990 Surgery70010-79999 Radiology80048-89356 Pathology and Laboratory90281-99602 MedicineNow that you have a grouping of the codes let's take this one step further. When you open your CPT manual for 2008 most CPT books have color coordinated Tabs based on the Grouping of the Procedure Codes. In my 2008 CPT manual the grouping is in this format:99201-99499 Evaluation and Management - Tab Color RED00100-01999, 99100-99140 Anesthesiology - Tab Color Blue10021-69990 Surgery - Tab Color Green70010-79999 Radiology - Tab Color RED80048-89356 Pathology and Laboratory - Tab Color Blue90281-99602 Medicine - Tab Color GreenMemorizing the Tab colors and the grouping will help you quickly pull up the correct code/descriptions when coding or reviewing procedure codes ... More About: Section
Listing of 2008 Discontinued HCPCS Codes
2008-03-21 17:10:00 These are a handful of discontinued HCPCS Healthcare Common Procedure Coding System codes starting on Jauary 1st 2008 -K0553 Combination oral/nasal mask, used with continuous positive airway pressure device, eachK0554 Oral cushion for combination oral/nasal mask, replacement only, eachK0555 Nasal pillows for combination oral/nasal mask, replacement only, pairL1855 Knee orthosis, molded plastic, thigh and calf sections, with double upright knee joints, custom-fabricated L1858 Knee orthosis, molded plastic, polycentric knee joints, pneumatic knee pads (CTI), custom-fabricatedL1870 Knee orthosis, double upright, thigh and calf lacers with knee joints, custom-fabricatedL1880 Knee orthosis, double upright, non-molded thigh and calf cuffs/lacers with knee joints, custom-fabricated Q4087 Injection, immune globulin, (Octogam), intravenous, non-lyophilized (e.g. liquid), 500 mg Q4088 Injection, immune globulin, (Gammagard liquid), intravenous, non-lyophilized, (e.g. liquid), 500 mgQ4091 Inje... More About: Listing , Codes
Procedure Code J7613 denied change to J7603
2008-03-21 16:54:00 Starting on January 1st 2008 you may have seen denials on the J7613 procedure code. If you modify that code to reflect as J7603 and rebill the claim you will get paid out.As of January 1st 2008 the following codes have been deleted:J7611 - Albuterol, noncompounded, concentrated form, 1 mgOther names: AccuNeb, Proventil, Respirol, VentolinJ7612 - Levalbuteral, noncompounded, concentrated form, o.5 mgOther names: Xopenex HFAJ7613 - Albuterol, noncompounded, unit dose, 1 mgOther names: AccuNeb, Proventil, Respirol, VentolinJ7614 - Levalbuterol, noncompounded, unit does, 0.5 mgOther name: XopenexThe code to use in these deleted codes place as of Jan 1st 2008:J7602 - Albuterol, inhalation solution, non-compounded, unit dose, 1 mg (Albuterol) or per0.5 mg (Levalbuterol) J7603 - Albuterol, inhalation solution, non-compounded, unit dose, 1 mg (Albuterol) or per 0.5 (Levalbuterol) Additional codes added for Nebulizers Added Jan 1st 2008J7604 - Acetylcysteine, inhalation solution, compounded ... More About: Change , Code
Medicare Interactive Voice Response IVR phone numbers by State
2008-03-21 15:22:00 If you ever need the phone number for Medicare Part A or Medicare Part B Interactive Voice Response (IVR) system you can locate your states number here:Medicare A IVR Medicare B IVR Medicare IVR State 866-539-5598 866-539-5598 Medicare Part A and B IVR phone number for Alabama866-277-7287 877-908-8431 Medicare Part A and B IVR phone number for Alaska866-277-7287 877-908-8431 Medicare Part A and B IVR phone number for Arizona877-207-4251 877-908-8434 Medicare Part A and B IVR phone number for Arkansas866-277-7287 877-591-1587 Medicare Part A and B IVR phone number for N California866-277-7287 866-502-9054 Medicare Part A and B IVR phone number for S California866-839-2441 877-908-8431 Medicare Part A and B IVR phone number for Colorado877-567-7205 866-419-9458 Medicare Part A and B IVR phone number for Connecticut877-567-7205 877-391-2610 Medicare Part A... More About: Phone , Numbers
Durable Medical Equipment Regional Carriers Contact List
2008-03-21 00:52:00 Have you ever spent time trying to identify a states contact information for Medicares Durable Medical Equipment ? Here is the official Medicare Durable Medical Equipment Regional Carriers Contact information by State.Medicare Durable Medical Equipment Regional Carriers Contact ListDMERC State website DMERC Region C Alabama http://www.cignamedicare.com Provider # 866-270-4909DMERC Region D Alaska http://www.noridianmedicare.com Provider # 866-243-7272DMERC Region D Arizona http://www.noridianmedicare.com/ Provider # 866-243-7272DMERC Region C Arkansas http://www.cignamedicare.com Provider # 866-270-4909DMERC Region D N California http://www.noridianmedicare.com Provider # 866-243-7272DMERC Region D S California http://www.noridianmedicare.com Provider # 866-243-7272DMERC Region C Colorado http://www.cignamedicare.com Provider # 866-270-4909DMERC Region A Connecticut www.medicarenhic.com Provider # 866-419-9458DMERC Region A Delaware www.medicarenhic.com Provider # 866-419-9458DMERC ...
How to use Medicares Interactive Voice Response (IVR)
2008-03-20 21:28:00 For the states of Illinois, Michigan, Minnesota and Wisconsin you can call Medicare Interactive Response (IVR) at these numbers:To use the IVR, call:Illinois (877) 908-9499Michigan (877) 567-7201Minnesota (877) 908-8470Wisconsin (877) 567-7176 IVR hours:Monday ? Friday 6:00 am ? 6:00 pm CT*Saturday 7:00 am ? 12:00 pm CT**Please note that the functions which require a Provider Transaction Access Number (PTAN) to be entered, such as eligibility and claim status, have limited hours due to system availability. The hours vary by state and option.Information you need to use the Interactive Voice Response (IVR) system.PTAN numberPatients namePatients Medicare number (9 numbers followed by a letter)Patients Date of BirthDate of Service MMDDYY or MMDDCCYYTelephone with handset or headset (do not use speakerphone or cell phone)Knowledge of how use the touch tone keypad (this one takes a bit of skill to perform)Enter the patients Medicare Number through IVRPatients Medicare #: 123456789AEntere...
How easy is it to be a Medical Biller?
2008-03-20 20:35:00 Any medical billing service who reads this will probably want to tar and feather me but the truth is Medical billing is quite easy. It's about the desire and willingness to learn the proper foundation to a good medical billing and collections process.If you want to break medical billing processes down to simple steps:1. Doctor treats a patient2. Doctor complets a form (encounter, Charge Slip, Routing Slip)3. The form makes it's way to the billing department4. The billing department is responsible for many aspects at this point but to keep things simple lets just say they convert the form into a claim and bill the insurance carrier.5. The claim gets paid out6. Payment is posted to the software7. Patient is billed8. Patient pays the billWow! That was simple however; lets add a few medical billing "problems" to this -Eligibilty - Does the patient being treated actually have insurance even though they present a ins cardMailing Address - Did the patient give us a legit mailing address ... More About: Easy
Save time by not calling Medicare on denied claims
2008-03-20 20:05:00 Time is money and calling insurance carriers some consider is a waste of time. I don't mind calling the insurance carriers but I normally do my own research on the claim prior to placing the call.I find that reading Explanation of Benefits can be tricky for some people and I think in my next blog I will write about EOB's and how to read them but for now let's look at some tricks in reading Medicare 's EOB's.Medicare says that these questions are becoming their top tiered questions -Call: CO-16 this code usually means the claim denied as unprocessable because information was missing or invalidResolution: Review the next Remittance Advice code under the CO-16 for the reason why the claim was denied.Call: I'm working from a reportResolution: Medicare would like clients to review the Remittance Advice tied to the Explanation of Benefits or Electronic Remittance Advice prior to calling on any claim (this means they would like you to review documentation supplied prior to calling the... More About: Time , Calling , Claims , Save
What is a PTAN number?
2008-03-20 19:55:00 When calling Medicare you will need to know your doctors Provider Transaction Access Number or PTAN. In short this is the doctors current legacy provider Number with Medicare.I am not sure why they needed to make this step so confusing for billing offices (i.e. changing the name of it and when you ask them what it is they won't tell you making it seem mysterious) but if you don't have your PTAN number you aren't going to get assistance with Medicare.In order to process your phone calls quickly it's best to have this information ready to shoot off:*Provider Transaction Access Number (PTAN)* The name of the office - This must be specific to the PTAN reported* The Health Insurance Claim Number (HICN) of the patient in question* The patient?s name as it appears on the Medicare card* The date of service in question* Any Remarks codes and descriptions from the Standard Provider Remittance (SPR) for the claim in question* Your question* Your contact information like telephone # and ext...
Medicare covers cardiovascular screening blood tests
2008-03-20 17:40:00 February is American Heart Month and I know it's now March but I feel that this is important to blog about this topic. Did you know that the Number 1 cause for death in the united states is Heart Disease? The 3rd cause of death is stroke.So as a patient what are your options to identifying if you are at risk? The next time you are in the office with your doctor ask them to take blood work to compare your #'s to the ones below.* Total Cholesterol Test* Cholesterol Test for High-density Lipoproteins* Triglycerides TestLets break these tests down to identify good results vs. high risk results.The Total Cholesterol Test ResultsDesirable: Under 200 milligrams per deciliter (mg/dL)Borderline high: 200 to 239 mg/dLHigh risk: 240 mg/dL and higherCholesterol Test for High-density Lipoproteins (you want to score high on this test)Desirable: An HDL 60 mg/dL or above helps protect against heart diseaseHigh Risk: Men that score 37 mg/dL or Women that score below ... More About: Blood , Covers , Medicare , Tests , Cardiovascular
When to get Flu Shots
2008-03-20 16:22:00 Eeach year we hear on the news, radio, internet to get your flu shot as early as possible before they run out. Well, this year maybe a good time to get a flu shot if you haven't already.I have been talking to a lot of patients (while collecting on their outstanding balances - I am in the medical billing industry) and they are telling me nasty stories about this horrible flu that is going around. It includes things like dizziness, diaherea, stomach issues and not being able to go to work for 3-5 days. Of course, sometimes I wonder why patients tell someone over the phone who called to collect on their outstanding bills about having to run to the bathroom, not going to work because what do you do sit on the toilet all day.... (gross)So you maybe asking yourself when do you get a flu shot? Flu shots in the US are given late October through March; but flu season can last into the month of May.Who should get flu shots?*All members of a medical office should be given a flu shot*Anyone w... More About: Shots , Medicare
QW modifier - CLIA waived Test
2007-10-22 23:25:00 All clinical laboratory improvement amendments (CLIA) of 1988 require all testing sites to have one of the following certificates to perform clinical laboratory testing:Certificate of WaiverCertificate of AccreditationCertificate of RegistrationCertificate of Physician-Performed MicroscopyEach CLIA certificate allows the lab to perform certain tests. Two CLIA certificates prevent holders to certain test proedures: Certificate of Waiver (1) and Certificate of Physician-Performed Microscopy (4).If a service that is a performed by the Lab is not covered under your CLIA certificate you can not bill the patient for this service and these codes will be billed with Modi fier QW. The claim must also have the correct CLIA number on the claim to be billed.Current Waived Test s under CLIA83001QW Genosis Fertell Female Fertility Test 84443QW Jant Pharmacal Accutest TSH {Whole Blood}86308QW Signify Mono Whole Blood 86308QW Clearview MONO Whole Blood82465QW Cholestech LDX (Lipid Profile - ALT (GPT)... More About: Medicare , Modifier
CR Modifier in use with Hurricane Katrina Victims & future disasters
2007-10-22 23:14:00 The CR Modifier code was initially created for Hurrican Katrina victims but will stay in use for Future Disasters . Using the CR modifier tells Medicare that you attempted to retain the patients existing health care records, current health status and/or verification of the patients Medicare or Medicaid Benefits.If, by chance the patient did not have Medicare benefits Medicare states they will pay out to the provider on these claims unless they identify fraud or abuse by the medical practice. More About: Hurricane Katrina
How quickly does NPPES update crosswalk
More articles from this author:2007-10-06 21:58:00 Scenario:Office is submitting claims and gets rejections M340, M379, M341, M380, M343, M381, M347, or M382 which are all NPI error messages from Medicare. These files are deleted by Medicare at the EDI department. (or if your state is not deleting them you will be told it's informational meaning you should fix this issue as soon as possible but Medicare will still process your claim)The office will get Prepass reports from Medicare that state informational somewhere on the report along with the words file is deleted (these are not good things). This can mean several things:1. The provider is not listed on the crosswalk *to validate the providers NPI # visit this blog: http://askamedicalbiller.blogspot.com/200 7/10/how-to-validate-your-medical-provide rs.html2. The provider is listed in NPPES however; the claims are not transmitting with the correct NPI#'s in the right areas of the electronic claims* call your practice management software or reference documentation to identify the ... More About: Update 1, 2, 3 |
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