Thursday, September 25, 2008

RelayHealth offers direct connection with Kaiser Permanente

Kaiser Permanente of Southern California now offers a direct connection with RelayHealth Clearinghouse. Starting September 24th 2008 all claims can be submitted using CPID# 1703 & 4576.

1703 - Kasier Permanente of Southern California Professional CMS-1500 claim format
4576 - Kaiser Permanente of Southern California Institutional UB-04 claim format

No EDI Agreements required for the submission of electronic claims. Kaiser supports 277 unsolicited reports and the RelayHealth standardized payor reports.

Kaiser has specific edits to be aware of when submitting claims electronically. RelayHealth will kick out a claim prior to forwarding them on to Kaiser for these issues:

Edit 01 version 0096C: In Loop 2010CA, NM109 must be 8-12 numeric if present, otherwise Loop 2010BA, NM109 must be 8-12 numeric.
Fix: 2010CA is a patient Name field or 2010BA is the Subscriber Name field

EDIT HU version 0019C: In Loop 2010AA, NM108 must be equal to XX
FIX: 2010AA is the Reporting Billing Provider Identification Code Qualifier field

Edit HU version 0020C: In Loop 2010AB, NM108 must be equal to XX
Fix: 2010AB is Pay to Provider Identification Code Qualifier

Edit HU Version 0022C: In Loop 2310B (professional CMS-1500)/2310C (institutional UB-04), NM108 must be equal to XX
Fix: Referring Provider Identification Code Qualifier


Interested in additional Online Medical Billing and Coding articles? Then click out Billing and Coding Online Courses

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Michigan Medicaid waiting list for CHAMPS to bill claims

Here is a interesting concept Michigan Medicaid (CPID#2480/3512) is asking that all clients who register EDI Agreements with CHAMPS Medicaid wait a full month from the date the application is approved to bill claims.

The issue is they have received so many requests the approvals are going through faster then they can handle the electronic software setup. If you begin submitting claims prior to this month you will only receive electronic claim rejections.

Any questions you may call Medicaid CHAMPS at 888-643-2408. PS - please be nice to them! Remember the people you are talking to are not the ones to blame for claim rejections. It's not their fault.

New Note: September 26th Update: Provider enrollment re-validation deadline has been changed to October 1st. For providers that have not re-validated by October 1st will be disenrolled. Please complete EDI Agreements immediately.

Learn more about Electronic Medical Billing and Coding at this site medical billings and health insurance claims

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Wednesday, September 24, 2008

Medical Offices require easy to learn Microsoft Office 2007 Word training videos

DreamForce LLC, inventor of easy to learn, Microsoft Office 2007 training videos and medical billing training videos has been in business for over 6 years. DreamForce has extensive knowledge in teaching many business sectors including medical, financing, and project management groups giving us great insight to answering support calls immediately, thinking outside of the box to resolve client's complex Microsoft or Medical Billing issues and getting the offices back on track.

Today we had a client call us from the Medical Industry. She was a front office representative of a multi-specialty practice. Her situation was the provider was moving, wanted to send a postcard to all patients and asked his staff to print labels and mail the postcards within 24 hours. Sounds easy right? Well, for her it was scary. No one had a clue how to create labels and worse yet; they had only recently upgraded to Vista Operating System and had no clue how to use Microsoft 2007 Word. We have consulted this medical office in prior situations so they called us.

We directed them to our Microsoft Office 2007 training videos, suggested web-based training and of course gave her step by step instructions on how to create the labels. We worked with her in exporting her data from the Practice Management Software (billing software), and then showed her how to create and format labels using Merge Fields. She was ecstatic, thanked us and then for the first time in those 10 minutes of the phone call you could hear a smile over the phone. After hanging up we sent a courtesy email of the steps discussed for future use.

Over the last year we have seen a huge trend of medical providers wanting to go paperless through a EMR product or their practice management software but simply don't make the transition because of lack of knowledge of Microsoft Word or lack of time to learn the new features. Most web-based practice management software programs are now heavily integrated with Microsoft so they have a huge impact on medical practices. Not only do we teach doctors how to use Microsoft 2007 but we also show them how it's integrated into their Practice Management Billing Software or EMR product. Doctors and billing services are now dealing with Access, Open Database Connectivity (ODBC), Comma Separated Value (CSV) reports, Word Templates, Forms Mail Merge, and Customization of medical chart documents along with many other programs.

Doctors and billing services don't really have time to "figure" out how the software products completely work. They need someone to show them the step by step's specific to their needs for that moment. With our training videos this need is filled. Anyone can train on the specific area they need, practice it with our examples, and master it. It truly is that simple.

Please visit our website to view all training videos for Level 1, Level 2 and Level 3 for Microsoft Word 2007 training videos.


For more course information on Medical Billing check out Online Medical Coding and Billing Courses


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Tuesday, September 23, 2008

2008 Correction Payment Fees for Clinical Laboratory Travel Codes P9603 and P9604 for Collection of Specimens

Medicare Part B insurance, will reimburse CLIA's for the services of a specimen collection and travel allowance of a laboratory technician to draw a specimen from either a nursing home patient or homebound patient under Section 1833(h)(3) of the Social Security Act. Payment is made based on the clinical laboratory fee schedule.

The P travel codes allow for payment of the travel allowance either on a per mileage basis (P9603) or on a flat rate per trip basis (P9604). Payment of the travel allowance is made only if a specimen collection fee is also payable.

The travel allowance fee schedule is to help cover the estimated travel costs of collecting the specimen, including the laboratory technician’s salary and travel expenses.

The per flat rate trip basis P9604 is $9.55 and should be used for trips under 20 miles round trip. If your distance is longer than 20 miles round trip or you stop to pick up a Non-Medicare specimen in the same trip you will want to use the per mile P9603 $1.035 fee.

On August 1, 2008, the per mile allowance rate of $1.035 cents per mile was computed using the Federal mileage rate of $0.585 cents per mile for automobile expenses plus an additional $0.45 cents per mile to cover the technician’s time and travel costs. Medicare contractors have the option of establishing a higher per mile rate in excess of the minimum of $1.035 cents per mile if local conditions warrant it.

Under either method (i.e., flat or per mile travel allowance), when one trip is made for multiple specimen collections (e.g., at a nursing facility), the travel payment component is prorated based on the number of specimens collected on that trip (for both Medicare and non-Medicare patients) either at the time the claim is submitted by the laboratory or when the flat rate is set by the Medicare contractor.


Medicare Notice: Medicare will not reprocess your claims with the updated Fee Schedule pricing unless you bring it to their attention and ask that they reprocess the claim. It is also recommended to raise your charge fee sctructure for these two procedure codes P9603 and P9604.

Procedure Codes Affected:
P9603 Calendar Year 2008 $1.035 per mile
P9604 Calendar Year 2008 $9.55 per Flat-rate trip


Real Life Billing Scenarios

Example 1: On August 2, 2008, a ARUP laboratory technician travels 60 miles round trip from a lab located in SLC to a Ogden location, and back to the lab to draw a single Medicare patient’s blood. The total reimbursement would be $62.10 (60 miles x 1.035 cents a mile), plus the specimen collection fee.

Example 2: On August 2, 2008, a ARUP laboratory technician travels 40 miles from the SLC lab to a Medicare patient’s home to draw blood, and then travels an additional 10 miles to a non-Medicare patient’s home and then travels 30 miles to return to the SLC lab. The total miles traveled would be 80 miles. The claim submitted would be for one half of the miles traveled or $41.40 (40 x 1.035), plus the specimen collection fee.


Example 3: A ARUP laboratory technician travels from the SLC laboratory to a single Medicare patient’s home and returns to the SLC laboratory without making any other stops. The flat rate would be calculated as follows: 2 x $9.55 for a total trip reimbursement of $19.10, plus the specimen collection fee.

Example 4: A ARUP laboratory technician travels from the SLC laboratory to the homes of five patients to draw blood, four of the patients are Medicare patients and one is not. An additional flat rate would be charged to cover the 5 stops and the return trip to the SLC lab (6 x $9.55 = $57.30). Each of the claims submitted would be for $11.46 ($57.30 /5 = $11.46). Since one of the patients is non-Medicare, four claims would be submitted for $11.46 each, plus the specimen collection fee for each.

Example 5: A ARUP laboratory technician travels from the SLC laboratory to a nursing home and draws blood from 5 patients and returns to the laboratory. Four of the patients are on Medicare and one is not. The $9.55 flat rate is multiplied by two to cover the return trip to the laboratory (2 x $9.55 = $19.10) and then divided by five (1/5 of $19.10 = $3.82). Since one of the patients is non-Medicare, four claims would be submitted for $3.82 each, plus the specimen collection fee.

Note** At no time will a laboratory be allowed to bill for more miles than are reasonable or for miles not actually traveled by the laboratory technician.

To read more about Medicare updates including Health Billing Insurance Information check out Medicare Medical Coding and Billing Courses

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Payment witholding if providers who bill to Medicare owe the IRS

If you are in the medical billing industry and you receive Medicare EOB's or Remittance Advice reports that reflect a provider level adjustment code as "WU" please read the following message.

As of October 1, 2008 Medicare can withhold 15% of the providers payments and reimburse the IRS for any outstanding Taxes owed by the provider or facility of services. If you begin receiving WU codes in the PLB03-1 data field you can call the IRS toll free at 1-800-829-3903 number. This information will also be found in the PLB03-2 data field located on the Remittance Advice report.

*Note: Billers can not discuss tax issues with the IRS. Only the physician with the outstanding tax balance can speak with the IRS. Do not contact Medicare as they are instructed to collect by the IRS and will only stop doing so if the levy has been paid or other arrangements are made to satisfy the debt.

You maybe wondering why Medicare would take 15% of your payment and send it to the IRS. Well, the Taxpayer Relief Act of 1997, Section 1024, requires the IRS to reduce certain federal payments, including Medicare payments, to allow collection of overdue taxes.

In July 2000, the Treasury Department’s Financial Management Service and the IRS began the Federal Payment Levy Program (FPLP) which is authorized by Internal Revenue Code Section 6331 (h), as prescribed by Section 1024 of the Taxpayer Relief Act of 1997. Through this program, collection of overdue taxes through a continuous levy on certain federal payments is authorized. This includes federal payments made to contractors and vendors, including Medicare providers, doing business with the government.

IRS may reduce federal payments subject to the levy by 15 percent, or receive payment in full if it is less than 15 percent of the complete Medicare Insurance payment.


Additional Medical Billing and Codingquestions are answered here: Online Medical Coding and Billing Courses

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Podiatrist and Medicare Claim Billing with 837 claims

Medicare is identifying that Podiatrists are having issues submitting clean claims using the ANSI 837 file format. If you are billing for a podiatrist that performs routine foot care services, and you are identifying lack of payment on Medicare claims please follow these suggestions:

1. Enter "Date Last Seen (DLS)" in Loop 2300 with the DTP segment and 304 Qualifier
- DLS is the most current date the patient was seen by the attending physician for the services rendered and is required on the claim

Example: DTP*304*D8*20080922~

- Date/Time Qualifier 304 must be included on the claim (used to convey dates associated with the information contained in the corresponding EB Loop)

2. Enter supervising/attending NPI in Loop 2310E, NM109 segment with a DQ indicator. XX will be in segment NM108.
- Supervising Providers Name must be submitted on the claim
- Entity Identifier Code must be DQ
- Supervising Provider UPIN must be submitted

Another note: If you received payment on claims submitted incorrectly (i.e. not billing this information in this format) Medicare is requesting that you refund all payments made and have the claims reprocessed under the correct format.

Learn more about Electronic Medical Billing and Coding at this site medical billings and health insurance claims

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Waived CLIA Tests for Medicare and approved by the FDA

If you are a certified CLIA facility, you know that the Centers for Medicare & Medicaid Services (CMS) only pay for laboratory tests categorized as waived complexity under CLIA in facilities with a CLIA certificate of waiver, and if the laboratory claims are edited at the CLIA certificate level.


Once new waived tests are approved by the FDA they become valid for use. The new waived tests announced by CR 6179 (and their effective dates) are in the following table:


Note: QW modifier tells Medicare that these are waived tests and should always be billed on the claim with the correct procedure code.


CPT: Modifier Approved Date: Description:
87880 QW June 28, 2007 PSS World Medical Select Diagnostics Strep A Twist
87880 QW March 19, 2008 Jant Pharmacal Accutest Integrated Strep A Rapid Test Device
87880 QW March 19, 2008 Inverness Medical Biostar Acceava Strep A Twist
87880 QW April 8, 2008 Diagnostic Test Group Clarity Strep A Rapid Test Strips
80061 QW April 14, 2008 Abaxis, Piccolo xpress Chemistry Analyzer {Lipid Panel Reagent Disc} (Whole Blood)
82465 QW April 14, 2008 Abaxis, Piccolo xpress Chemistry Analyzer{Lipid Panel Reagent Disc} (Whole Blood)
83718 QW April 14, 2008 Abaxis, Piccolo xpress Chemistry Analyzer{Lipid Panel Reagent Disc} (Whole Blood)
84478 QW April 14, 2008 Abaxis, Piccolo xpress Chemistry Analyzer{Lipid Panel Reagent Disc} (Whole Blood)
82465 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Lipid Panel Plus Reagent Disc} (Whole Blood)}
82947 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Lipid Panel Plus Reagent Disc} (Whole Blood)}
82950 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Lipid Panel Plus Reagent Disc} (Whole Blood)}
82951 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Lipid Panel Plus Reagent Disc} (Whole Blood)}

82952 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Lipid Panel Plus Reagent Disc} (Whole Blood)}
83718 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Lipid Panel Plus Reagent Disc} (Whole Blood)}
84478 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Lipid Panel Plus Reagent Disc} (Whole Blood)}
84450 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Lipid Panel Plus Reagent Disc} (Whole Blood)}
84460 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Lipid Panel Plus Reagent Disc} (Whole Blood)}
82042 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Liver Panel Plus} (Whole Blood)
82150 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Liver Panel Plus} (Whole Blood)
82247 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Liver Panel Plus} (Whole Blood)
82977 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Liver Panel Plus} (Whole Blood)
84157 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Liver Panel Plus} (Whole Blood)
84075 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Liver Panel Plus} (Whole Blood)
84450 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Liver Panel Plus} (Whole Blood)
84460 QW April 14, 2008 Abaxis Piccolo xpress Chemistry Analyzer{Liver Panel Plus} (Whole Blood)
89300 QW June 12, 2008 SpermCheck Vasectomy
83520 QW June 13, 2008 HemoCue Albumin 201 System


In addition to this list the CR 6179 also announces that:
The new waived CPT/HCPCS code 87809 has been assigned to the infectious agent antigen detection by immunoassay with direct optical observation; adenovirus. The HCPCS code assigned to the Rapid Pathogen Screening PRS


Adeno Detector test has been changed to 87809QW with an effective date of January 1, 2008.


•The new waived CPT code, 83520QW has been assigned for the albumin test performed using the A HemoCue Albumin 201 System with an effective date of June 13, 2008.


•As of May 1, 2008, the following test systems are either discontinued or are no longer manufactured, and their names have been removed from the list of tests granted waived status under CLIA:oMetrika A1c Now for Prescription Home Use (K020234),oMetrika A1c Now™ - Professional Use (K000887),oMetrika A1c Now for Professional Use (K020235),oMetrika DRx® HbA1c (Professional Use Test System),oBayer DCA 2000 – glycosylated hemoglobin (Hgb A1c), andoBayer DCA 2000+ - glycosylated hemoglobin (Hgb A1c).


•The Bayer A1CNow+ {For Professional Use} was granted waived complexity categorization because of its home (over the counter) use. Effective May 1, 2008, the CPT code for Bayer A1CNow+ {For Professional Use} test system has been changed from 83036QW to 83037QW on the list of tests granted waived status under CLIA.

The attachment to CR 6179 includes the list of tests granted waived status under CLIA. The tests mentioned on the first page of this attachment (i.e., CPT codes: 81002, 81025, 82270, 82272, G0394, 82962, 83026, 84830, 85013, and 85651) do not require a QW modifier to be recognized as a waived test.

If you have previously billed claims incorrectly resubmit them to your Medicare carrier or MAC and request them to review and reprocess your claims with these new changes.


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Updated Draft of MLN Matters on Limitation on Recoupment for Provider, Physicians and Suppliers Overpayment

On September 18, 2008 Medicare updated a MLN Matters Articles to clarify page 2 and delete unneccesary language on pages 5 & 9. For the full details of this updated document please visit:

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6183.pdf

Background of this update:
Before the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) was enacted, a provider’s electing to appeal an overpayment determination did not affect Medicare’s prerogative to recover the debt. However, through an amendment of Title XVIII of the Social Security Act (the Act); MMA Section 935 changed this process, by adding a new paragraph (f) to section 1893 of the Act.

This amendment requires the Centers for Medicare & Medicaid Services (CMS) to change: 1) the way it recoups certain overpayments to providers, physicians and suppliers; and 2) how it pays interest to a provider, physician or supplier whose overpayment is reversed at subsequent administrative (Administrative Law Judge (ALJ)) or judicial levels of appeal.

CR 6183 describes these changes to the providers, physicians and suppliers overpayment recoupment process. Specifically, Section 1893 (f)(2)(a) of the Social Security Act protects providers physicians, and suppliers during the initial stages of the appeal process (both first level
appeal – contractor redetermination, and second level appeal -- Qualified Independent Contractor (QIC) reconsideration) by limiting the recoupment process for Medicare overpayments while the appeals process is underway.

It requires that when a valid first or second level appeal is received from a provider on an overpayment, subject to certain limitations (see below), CMS and its Medicare contractors may not recoup the overpayment until the decision on the redetermination and/or reconsideration has been rendered.

The article (link above) provides more detail and clarifies which overpayments are subject to limitation on recoupment and which types of overpayments are not subject to this limitation. Make sure that your billing staff are aware of these changes.

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Medicare as Secondary Insurance

Has your medical office ever received a request for repayment by the primary insurance carrier; the patient has a secondary insurance through Medicare but was never billed because the primary paid above Medicare's allowed amount so the balance was adjusted off?

Medicare has a 1 year timely filing policy giving most clients ample time to resolve claim issues and submit a clean claim. However; sometimes you will receive a primary insurance payment in full and 2 or 3 years later the insurance carrier will identify they weren't the primary insurance carrier and ask for a full refund. Now what do you do?

For Future Claims take these steps to make sure this never happens to you. Bill Medicare regardless how the primary insurance carrier paid (yes, even if they paid in full.)

  • Submit all secondary claims to Medicare even if the primary paid in full
  • The medical claim will reflect in Medicare's software to prove timely filing
  • Patients might meet part of their deductible even if the primary paid in full and to ease your patients accounting bill the medical claim
  • Medicare uses information on the medical claim and submits it to the National Claims Processing File
  • If the primary insurance carrier requests a refund at any point you will know you are safe because you have proved timely filing with Medicare

But this has happened to me now - what can I do?

  • Take a copy of the Refund Request, EOB's, Claim and any other kind of proof you can show to Medicare that you attempted to collect this correctly through the primary insurance carrier and submit to Medicare.
  • If you receive a denial for late filing appeal asking Medicare to waive the claim timely file limit for good cause. Again attach any and all supporting documentation plus a really nice well written appeal letter.

Medicare has the option to evaluate and make a determination based on the supporting documentation.

Medicare states it the doctors responsibility to identify who the correct primary insurance carrier is. Although sometimes the primary insurance carriers are small companies that have slow or bad software programs and they don't update paperwork for weeks or months causing these kinds of issues....

  1. Always contact the Interactive Voice Response (IVR) and verify files are update
  2. Contact the Coordination of Benefit Contractor (COBC) (1-800-999-1118) and follow instructions if information is not correct.
  3. Always bill Medicare as a secondary even if the primary insurance paid in full


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2 Insurance Carriers dropping Claim Status reports through Clearinghouse

If you are currently billing claims through RelayHealth and submit to Principal Financial Group and Nippon Life Insurance Company of America you may notice changes in your current EDI reports.

In June of 2008 RelayHealth had identified that the 277U reports were being sent with missing or incorrect patient information appearing on the reports. They notified the insurance carriers who had been working to correct the issue. At this time the decision is too stop receiving the 277U report.

Insurance Carriers: CPID#6420 & 4528 Principal Financial Group, CPID# 6443 & 6539 Nippon Life Insurance Company of America
Report being Dropped: 277U
277U represents what EDI Report? Claim Status of claims submitted electronically through a report
How do we now check claim status?

  1. Visit principal.com and click on Provider Services on the Quick Link tab
  2. Visit principal.com/partners/providers/providersservices.htm
  3. Call the insurance carriers directly using the phone number on the back on the insurance card

If at any point this information gets updated I will notify you on this blog:

If your practice management does not receive 277U reports (claim status) contact them immediately and ask them for this service. It will save your office time and money from having to research all of the outstanding claims when it can be completed through reports like this.

Questions on Electronic Medical Billing and Claims then click here medical claims electronic billing
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Wisconsin's ForwardHealth Interchange has new Release Date

Wisconsin’s Medicaid Management Information System (MMIS) will be retiring soon and replaced by a program called ForwardHealth Interchange. This new software allows providers and clearinghouses, vendors & trading partners to access more information while online.

Wisconsin had initially planned on being ready for this change on October 13th 2008 but has released a new deadline. Also, if you are a trading partner or provider that submits claims electronically directly to Wisconsin's Medicaid program you will need to "test" your connection.

What is ForwardHealth interchange? Wisconsin's new claims processing system
ForwardHealth interchage start date: November 10th 2008
More information: dhs.wisconsin.gov/forwardhealth

Additional
Medical Billing and Coding questions are answered here: Online Medical Coding and Billing Courses

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Florida Blue Cross Blue Shield NPI Deadline

Blue Cross Blue Shield of Florida has set a deadline to begin accepting NPI compliant 835 files only. If your doctor has not updated Florida Blue Cross Blue Shield with their NPI information prior to this deadline their electronic claims will be denied in incomplete information.

Insurance Carrier: Florida Blue Cross Blue Shield
Deadline to NPI-compliant 835: November 17th 2008

How to identify if NPI is on file:

Confused by Electronic Medical Claim billing then read these articles on Billing Health Insurance medical claims

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Care Plus Health Plans Electronic Claim Updates

Does your office use RelayHealth as your clearinghouse? Do you currently bill to Care Plus Health Plans? If your office is currently billing to Care Plus Health Plans please be advised that at this time you should update it to reflect as a new CPID#.

Insurance Carrier: Care Plus Health Plans
CPID#: 4281
Payor ID# for electronic transmission: 95092
Changes to: CPID# 2830 Care Plus
Payor ID# 65031

RelayHealth will automatically convert the CPID# 4281 to 2830 until October 16, 2008. On October 17th 2008 if your medical office does not update the CPID#'s you will begin receiving rejections that CPID# 4281 is no longer valid.

Key Words: RelayHealth, Clearinghouse Edits, Claims Updates, How to Bill Effectively, How to get Paid on Medical Claims, Medical Billing, Medical Collections, EDI Reports, EDI Edits, Care Plus Health Plan Rejections, Setting up Insurance Carriers Correctly.

Monday, September 22, 2008

Videotrainingpro.com for Exceptional Microsoft Office Online Training Programs

A Microsoft and Medical Billing Training Company, DreamForce LLC announces the release of online Microsoft 2007 training videos.

President of DreamForce LLC, and Microsoft Certified Application Specialist (MCAS) trainer, Kirt Kershaw, identified that the software training market was lacking online Microsoft Training Videos conducted by Certified MCAS trainers. Kershaw said, “I was surprised to find that people had no options of purchasing Microsoft Office videos from certified MCAS instructors. After identifying this through research I put a plan in place to create online training courses that allow clients to own the videos, not pay monthly subscription rates, and receive quality courses like they would in a live classroom setting all done by a MCAS certified trainer.”

DreamForce LLC set out to put this plan into motion. Each training video is first designed by creating an outline. Visual examples are then created so the end user can follow the instructions and watch how it works. Once all of the documentation is prepared, the training videos are recorded, edited, and published to the videotrainingpro.com website for purchase. Each level takes on average 4-6 weeks to create and offer over 3 hours of in-depth quality training conducted by Kirt Kershaw a certified MCAS trainer.

The result is the same type of training you would get if Kirt was on site training you live. The only difference is now you can pause, rewind, fast forward or skip through sections. You have complete control on when you want to learn and how much you can handle. The best part is you are paying 1/10th as much for these training videos if you had to go onsite somewhere and learn. Live onsite trainings can cost upwards of $250.00 per student. These videos are priced at an extremely affordable option for anyone that wants to learn Microsoft 2007.

Training Videos and CD’s can be purchased for all English speaking users from anywhere in the world including United States, Canada, Australia, United Kingdom and Ireland.

DreamForce LLC is a registered company with the Better Business Bureau.

Kirt Kershaw is an authority on training Microsoft’s Office: his credentials are Certified as a Master Microsoft Office Specialist Instructor for Microsoft’s Office 2000, XP, 2003 and 2007 (MCAS - he’s listed on Certiport’s website), Microsoft’s Project XP certified, CompTIA’s A+ certified. In addition, he participated in Certiport’s standard setting methodologies and procedures research project with Excel 2003 Expert exam materials.

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Thursday, September 18, 2008

When to send attachments with claims?

Are you still mailing paper claims to insurance carriers because you feel you need to attach supporting documentation for the processing of your insurance claim? Well, as more and more information is getting transmitted electronically it maybe possible to stop sending things by paper or at least eliminate the need for the majority of your claims.

Aetna Health Insurance has just released an announcement encouraging all medical offices to send all claims electronically including primary and secondary insurance claims. If for any reason they need supporting documentation they will notify you by EDI reports or through a EOB asking for this information.

Aetna Health Insurance for example is noticing they are still receiving a high volume of paper claims with attached paperwork. Anytime a claim comes through with attached paperwork it slows down the processing of your claim because they need to "touch" the claim by a human. This means your doctor will receive insurance payments later than normal from Aetna on these claims which hurts your office. They ask that in order to minimize the slowness of insurance payments to send everything electronically.

  • Aetna Insurance rarely needs progress notes
  • Aetna Health Insurance does not require paper copies of referrals. They have a computer system that tracks data from the referral system. If their is a match, the claim is quickly processed.
  • If Medicare was the primary carrier and MA18 appears on a Medicare explanation of payment you do not need to mail in a secondary claim

If the claim does require any additional information they will notify you through EDI reports and EOB's.

In short if you are still sending high volumes of claims by paper contact those insurance carriers and identify if and how you can send them electronically to save time and money.

For those clients that bill using RelayHealth you will use CPID# 4500 and 6400 to bill to Aetna Health Insurance. Aetna Insurance accepts claims electronically as a primary and secondary.

Learn more about Electronic Medical Billing and Coding at this site medical billings and health insurance claims

Key Words: Aetna, Aetna Health Insurance, Health Insurance Aetna, Health Aetna, Insurance Aetna, Aetna Insurance, 6400, RelayHealth, McKesson, Clearinghouse, Paperwork, when to bill, how to bill, claims mailing, Medicare, primary electronic medical claims, secondary electronic medical claims, medical billing, medical collections, speed up processing time, clean claim submission, quicker reimbursement rates, speed up insurance payments,

Wednesday, September 17, 2008

How to fix CH 47 Missing Admission Date

If you are billing through RelayHealth clearinghouse you may find a claim exclusion code CH 47 Missing Admission Date.

Edit: CH 47 Missing Admission Date
Fix: First verify the POS/TOS is correctly added at the claim level. Once this is identified that the procedure was completed in the hospital add the Admission Date to the charge level. If the patient was treated in the office but the code was setup as POS Inpatient Hospital or TOS Surgery change these and save.

After fixing rebill the claim. This will not need to be a corrected claim since the claim was denied at the clearinghouse level and never reached the insurance carrier.

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How to fix CH 64 Invalid Carrier CPID Number

If you are billing through RelayHealth you may stumble across exclusions for a CH 64 invalid Carrier Direct CPID Number in my case 4301. If you are unsure of how to fix this exclusion please read the steps below:

Edit: CH 64 Invalid Carrier Direct CPID # 1350, 4303, 4301, 4302, 4300, 1391CO
Fix: EDI Agreements are not setup between your insurance carrier and RelayHealth
Recommendation: Contact correct party (some clients go through their practice management software while others can contact RelayHealth directly) to identify the status of your EDI Agreement. If no EDI Agreement is on file complete one through RelayHealth's website.
Why CPID# changed: You were probably billing with the Correct CPID# but RelayHealth could not identify the EDI Agreement and was forced to kick out the claims so they convert the CPID# to paper as to not send it electronically.

This situation actually happens extremely often for new clients just getting on board with RelayHealth or as they add new providers to their offices they forget to complete the EDI Agreements.

Claims do not need to be rebilled as corrected claims since they were never forwarded on to the insurance carrier to begin with but denied at the clearinghouse level.

Key Words: EDI Agreements, claim denial, denial code 64, exclusion, electronic claim, medical billing, how to fix, how to resolve, rebill claims, RelayHealth, Clearinghouse, New provider setup, billing medical provider claims, claim exclusion, CPID, Paper CPID, Electronic CPID, improper claim submission, invalid information, clean claim submission

2430-CAS REQUIRED WHEN 2430-SVD NE 2400-SV102

I am working with a client that received a RelayHealth Payor Message for Montana Medicare as 2430-cas Required when 2430-SVD NE 2400-SV102. She couldn't figure out why she is getting these denials so I reviewed how the patients were setup in the Practice Management software.

  • Medicare is the secondary payor for all of these denied claims
  • She has setup to bill Medicare secondary claims electronically
  • The Claim Adjustment Reason Codes were not added to the primary payment

Medicare cannot accept these claims electronically because the payment poster did not add the primary payment codes to the claim. Attach the primary claim adjustment reason codes and if you need assistance with what primary claim adjustment reason codes are view my initial blog about this information: Medicare Health Insurance Claim Adjustment Reason Codes

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Friday, September 12, 2008

Procedure Code 90669 and 90471

The other day a seasoned medical biller and coder emailed me an example that she was flagged with. She has two coding softwares to compare from and 1 software didn't mention she needed to bill the 90669 with the Admin charge while the other software told her she needed to add the Admin Charge.



She emailed me the sceanrio and asked me for my position on this edit. I emailed her the following:



I show that the Practice Management Software Claim Inspector edits are correct and that you can bill for the 90471 or 90472 Admin Injection codes. Explained as: Codes 90476 – 90748 identify the vaccine product ONLY. To report the administration of a vaccine/toxoid, the vaccine/toxoid product codes 90476 – 90749 must be used in addition to an immunization administration code(s) 90465-90474. Do not append modifier 51 to the vaccine/toxoid product codes 90476-90749.


She emailed me back that she had called Texas Medicaid and they verified she can bill with the Admin Codes.

I am adding this to my blog to remind others to never be afraid to ask questions or just "bounce" questions off of others. This is also a reminder that as nice as it is to have coding software they aren't always perfect.

The grouping of codes we reviewed were:
90476 - Adenovirus vaccine, type 4, live, for oral use
90477 - Adenovirus vaccine, type 7, live, for oral use
90581 - Anthrax vaccine, for subcutaneous use
90585 - Bacillus Calmette - Guerin vaccine (BCG) for tuberculosis, live, for percutaneous use
90586 - Bacillus Calmette-Guerin vaccine (BCG) for bladder, cancer, live, for intravesical use
90632 - Hepatitis A vaccine, adult dosage, for intramuscular use
90633 - Hepatitis A vaccine, pediatric/adolescent dosage-2 dose schedule, for intramuscular use
90634 - Hepatitis A vaccine, pediatric/adolescent dosage-3 dose schedule, for intramuscular use
90636 - Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use
90645 - Hemophilus influenza b vaccine (Hib), HbOC conjugate (4 dose schedule), for intramuscular use
90646 - Hemophilus influenza b vaccine (Hib), PRP-D conjugate, for booster use only, intramuscular use
90647 - Hemophilus influenza b vaccine (Hib), PRP-OMP conjugate (3 dose schedule), for intramuscular use
90648 - Hemophilus influenza b vaccine (Hib), PRP-T conjugate (4 dose schedule), for intramuscular use
90649 - Human Papilloma virus (HPV) vaccine, types 6, 11, 16, 18 (quadrivalent), 3 dose schedule, for intramuscular use
90650 - Human Papillomavirus (HPV) vaccine, types 16 and 18, bivalent, 3 dose schedule, for intramuscular use
90655 - Influenza virus vaccine, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use
90656 - Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use
90657 - Influenza virus vaccine, split virus, when administered to children 6-35 months of age, for intramuscular use
90658 - Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use
90660 - Influenza virus vaccine, live, for intranasal use
90661 - Influenza virus vaccine, derived from cell cultures, subunit, preservative and antibiotic free, for intramuscular use
90662 - Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use
90663 - Influenza virus vaccine, pandemic formulation
90665 - Lyme disease vaccine, adult dosage, for intramuscular use
90669 - Pneumococcal conjugate vaccine, polyvalent, when administered to children younger than 5 years, for intramuscular use
90675 - Rabies vaccine, for intramuscular use
90676 - Rabies vaccine, for intradermal use
90680 - Rotavirus vaccine, pentavalent, 3 dose schedule, live, for oral use
90681 - Rotavirus vaccine, human, attenuated, 2 dose schedule, live, for oral use
90690 - Typhoid vaccine, live, oral
90691 - Typhoid vaccine, Vi capsular polysaccharide (ViCPs), for intramuscular use
90692 - Typhoid vaccine, heat- and phenol-inactivated (H-P), for subcutaneous or intradermal use
90693 - Typhoid vaccine, acetone-killed, dried (AKD), for subcutaneous use (U.S. military)
90696 - Diphtheria, tetanus toxoids, acellular pertussis vaccine and poliovirus vaccine, inactivated (DTaP-IPV), when administered to children 4 years through 6 years of age, for intramuscular use
90698 - Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenza Type B, and poliovirus vaccine, inactivated (DTaP - Hib - IPV), for intramuscular use
90700 - Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use
90701 - Diphtheria, tetanus toxoids, and whole cell pertussis vaccine (DTP), for intramuscular use
90702 - Diphtheria and tetanus toxoids (DT) adsorbed when administered to individuals younger than 7 years, for intramuscular use
90703 - Tetanus toxoid adsorbed, for intramuscular use
90704 - Mumps virus vaccine, live, for subcutaneous use
90705 - Measles virus vaccine, live, for subcutaneous use
90706 - Rubella virus vaccine, live, for subcutaneous use
90707 - Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use
90708 - Measles and rubella virus vaccine, live, for subcutaneous use
90710 - Measles, mumps, rubella, and varicella vaccine (MMRV), live, for subcutaneous use
90712 - Poliovirus vaccine, (any type[s]) (OPV), live, for oral use
90713 - Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use
90714 - Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, when administered to individuals 7 years or older, for intramuscular use
90715 - Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use
90716 - Varicella virus vaccine, live, for subcutaneous use
90717 - Yellow fever vaccine, live, for subcutaneous use
90718 - Tetanus and diphtheria toxoids (Td) adsorbed when administered to individuals 7 years or older, for intramuscular use
90719 - Diphtheria toxoid, for intramuscular use
90720 - Diphtheria, tetanus toxoids, and whole cell pertussis vaccine and Hemophilus influenza B vaccine (DTP-Hib), for intramuscular use
90721 - Diphtheria, tetanus toxoids, and acellular pertussis vaccine and Hemophilus influenza B vaccine (DtaP-Hib), for intramuscular use
90723 - Diphtheria, tetanus toxoids, acellular pertussis vaccine, Hepatitis B, and poliovirus vaccine, inactivated (DtaP-HepB-IPV), for intramuscular use
90725 - Cholera vaccine for injectable use
90727 - Plague vaccine, for intramuscular use
90732 - Pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use
90733 - Meningococcal polysaccharide vaccine (any group(s)), for subcutaneous use
90734 - Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for intramuscular use
90735 - Japanese encephalitis virus vaccine, for subcutaneous use
90736 - Zoster (shingles) vaccine, live, for subcutaneous injection
90740 - Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (3 dose schedule), for intramuscular use
90743 - Hepatitis B vaccine, adolescent (2 dose schedule), for intramuscular use
90744 - Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use
90746 - Hepatitis B vaccine, adult dosage, for intramuscular use
90747 - Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule), for intramuscular use
90748 - Hepatitis B and Hemophilus influenza b vaccine (HepB-Hib), for intramuscular use
90749 - Unlisted vaccine/toxoid

Immunization Administration for Vaccines/Toxoids
Codes 90465 - 90474 must be reported in addition to the vaccine and toxoid code(s) 90476-90749.

Report codes 90465-90468 only when the physician provides face-to-face consulting of the patient and family during the administration of a vaccine. For any immunization administration of any vaccine that is not accompanied by the face-to-face physician counseling to the patient/family report codes 90471-90474.

Interested in additional Online Medical Billing and Coding articles? Then click out Billing and Coding Online Courses


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Medicare DME MAC new claim edit

For those clients that bill through RelayHealth and use the following CPID#'s please be aware of a new edit:

CPID# 7475 Medicare DME MAC Jurisdiction A
CPID# 7476 Medicare DME MAC Jurisdiction B
CPID# 7477 Medicare DME MAC Jurisdiction C
CPID# 7478 Medicare DME MAC Jurisdiction D

National Government Services (NGS) is currently sending a Warning Message B108 Billing Provider Not Authorized for Submitter. On October 1st 2008 RelayHealth will update this edit at which time we will post it here. Currently though if you are getting this edit please review how to fix the issue:

Edit: B108 Billing Provider not Authorized for Submitter
Fix: A EDI Agreement is required between the medical office, RelayHealth and Medicare DME. Please follow the correct steps to complete the EDI agreement. Hold all claims until the EDI Agreements are processed once approval has been received from RelayHealth re-submit all unpaid Medicare DME claims.
Complete EDI AG: visit collaborationcompass.com and click the Payor tab and Payor Agreements.

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Montana Blue Shield new claim exclusion edit

If you are currently billing to CPID# 7450 Montana Blue Shield please be aware of new a new claim edit that was added to RelayHealth on September 11, 2008.

Edit: 35 0042C Missing Referring Provider Info - in Loop 2300, if a ref segment with a 9F Qualifier is Present, then loop 2310A must be sent.
Fix: Loop 2310 is equivalent to Box 17 provider who referred the patient and Box 17A Referring Provider ID information. If this information is missing and you are indicating a 9F qualifier it will be rejected. Add the referring providers information and rebill the claim.


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Connecticut Blue Cross new Exclusion Edit

If you are billing to Connecticut Blue Cross CPID#3534 you will want to be aware of a new edit exclusion through RelayHealth.

On September 11, 2008 RelayHealth has added a new edit to be aware of:

Edit: 10 0001C Claim cannot have $0.00 dollar amount in Loop 2300, CLM02 Cannot be Zero
Fix: The Claim is going out with a Zero dollar Charge and Connecticut Blue Cross does not allow Zero dollar charges. They ask that you add a charge amount to your procedure codes and rebill the claim.

Key Words: Medical Billing Claims, Clearinghouse, RelayHeatlh, Electronic Claim Submission, Loop 2300, CLM02, Claim Edits, Exclusion edits, electronic medical billing, medical claims, health claims, medical billing and collections, Connecticut Blue Cross exclusion, medical billing classes online, online medical billing school, medical billing and coding courses online, courses online, medical billing classes, chiropractic software, online courses medical billing, medical office billing software, medical coding schools, medical coding courses, on line medical billing, medical billing programs, Medicare billing software

Monday, September 8, 2008

Selling your Medical Billing Service?

If you are interested in selling your medical billing practice please let me know. I have several clients interested in purchasing existing Medical Billing Companies. One client in particular is interested in purchasing existing doctors on AdvancedMD practice management software.

Also, if you are a doctor currently on AdvancedMD Practice Management software and are interested in outsourcing your billing to a medical billing service that is knowledgeable on the AdvancedMD Practice Management software please contact me.

To Contact: Select the comments option and enter your information as to how you would like me to contact you. I will not "publish" this information but will use it to contact you. With Spamming issues it causes a lot of problems if I release my email address so I prefer to be contacted this way.

Questions on Electronic Medical Billing and Claims then click here medical claims electronic billing
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In the Market to Sell your Medical Billing Business?

Are you in the market to sell your Medical Billing Business? I have several clients who are interested in purchasing existing Medical Billing Businesses. My clients have been running successful billing services for many years and currently have 80+ doctors each.

1 client is specifically looking for a Medical Billing Business that has medical providers on the AdvancedMD medical billing software. They are looking for a small to mid-size medical billing business that has hopefully run a successful billing structure. This client has been in the Medical Billing Industry for over 14 years and has over 90 providers. The Medical Billing is completed in the USA.

My other clients have no preference on what software the doctors or medical billing business are using at this time. They are mature medical billing companies and offer wonderful services to medical doctors.

If you are interested in being introduced to my clients please contact me with your information. I will keep it confidential and contact you or have the medical billing services contact you directly.

Confused by Electronic Medical Claim billing then read these articles on Billing Health Insurance medical claims

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Changes to New York Medicaid Electronic Claims

For all clients who are submitting claims to New York Medicaid effective September 1, 2008 New York Medicaid is requiring claims be submitted with both the NPI and the Legacy numbers until New York Medicaid announces the NPI only requirement.

NPI is required in the following Loops for Electronic Claim Submission:

Institutional Loops UB-04 claim format:
2010AA Billing Provider
2310A Attending Physician
2310B Operating Physician
2310C Other Provider loop (used for referring provider)
2420A Attending Provider
2420B Operating Physician
2420C Other Provider


Professional Loops CMS-1500 format:
2010AA Billing Provider
2010AB Pay-to provider
2310A Referring provider (required for DN and P3 qualifiers)
2310B Rendering Provider
2310D Service Facility
2310E Supervising Provider
2420A Rendering Provider
2420C Service Facility
2420D Supervising Provider
2420E Ordering Provider
2420F Referring Provider (required for DN and P3 qualifiers)


On September 5th 2008 RelayHealth will have a Provider Test Environment for NPI information. RelayHealth will notify clients of any changes that maybe required of them but for now please begin transmitting the Medicare Legacy and NPI numbers for the following CPID#'s.

CPID 1422 New York Welfare - Phase II
CPID 1500 New York Medicaid Title XIX - Phase II
CPID 1501 New York Medicaid Inpatient - Phase II
CPID 1502 New York Medicaid Outpatient - Phase II


Questions on Electronic Medical Billing and Claims then click here medical claims electronic billing
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Terminated Insurance Carriers from RelayHealth

As of August 29th 2008 CPID#4421 and 4432 are no longer eligible to submit claims electronically through RelayHealth.

CPID#4421 Managed Care America
CPID# 4432 Sheet Metal Workers

If you would like to submit your claims electronically to RelayHealth and have them drop the claims to paper (at a fee) you can use CPID# 4300.


As of September 3rd 2008 Healthways Wholehealth Network CPID#4740 has been added to submit claims to electronically through RelayHealth using the Professional format or CMS-1500. No EDI Agreements are required.

As of September 4th 2008 a new carrier was added to RelayHealth's website CPID# 5904 SunHealth Medisun (TMG Health) Institutional 4010A1 ANSI format for UB-04 claims. No EDI Agreements are required.

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How to fix a RelayHealth Edit

We received this exclusion code for CPID# 4417 through RelayHealth because somehow the medical biller received a different denial and after fixing during the re-billing phase through our Practice Management software selected to rebill the Secondary Insurance Carrier. The secondary insurance carrier was submitted and was denied with this exclusion because we had not posted the primary insurance carriers payment which of course is because they have never received the claim. Our scenario is probably way different as to why most medical offices are receiving this denial reason.

Edit: PA The Claim Adjudication Date (Loop 2330B, DTP)
What it means: Medicare Secondary Payer (MSP) information is missing
Fix: Add the MSP code to the claim and rebill

Loop 2330B DTP segment - Line Adjudication Date
The ANSI X12 Implementation Guide indicates the claim adjudication date by using a DTP segment in loop 2330B. The DTP01 element will contain qualifier 572, Date Claim Paid, to indicate the type of date that follows. DTP02 will contain qualifier D8 to indicate the format of the date. The DTP03 element will contain the claim adjudication date. The Claim Adjudication Date is required on all MSP claims and is used to report the date a claim was adjudicated or paid by the primary payer.

Example:
2330B/DTP segment syntax: DTP*573*D8*20080908~

DTP01 = 573 which indicates date claim paid
DTP02 = D8 indicating date format
DTP03 = Actual Primary Payer Adjudication Date

Claims that do not balance at the claim and line level will not be accepted into the processing system. The total primary payer paid amount (AMT*C4) plus the adjustment amounts in both the claim and line level CAS segments must equal the Total Submitted Charge (AMT*T3)

Confused by Electronic Medical Claim billing then read these articles on Billing Health Insurance medical claims

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How to read Payor Claim Data Reports

The Medical Industry is constantly changing and RelayHealth is no different. As of September 8th 2008 you will find new changes to your Payor Claim Data Report and Payor Report Data Files which should benefit medical billers in general.
RelayHealth has supplied the Payor Claim Data Report and Payor Report Data Files since November 2006. For those clients who use these reports find they are beneficial in early identification of claim denials and claim acceptances.
All Payor Claim Data Report and Payor Report Data File Codes:
A = Accepted Medical Claim
F = Acknowledged and/or Forwarded
E = Remittance Information
I = Request for Additional Information
M = Informational Messages
P = Pended
R = Rejected
U = Unknown
Z = Zero Payment Claim
For those who are not sure where to find these codes on the report please click on the picture to view a sample of the Payor Claim Data Report which shows claims accepted and excluded.
Key Words: Medical Billing, Medical Billing reports, How to read Clearinghouse reports, Payor Claim Report, New Edits, RelayHealth Reports, Reading, Electronic Claims, Electronic Clearinghouse, Excluded Claims

Aetna asking Medical Offices to submit secondary claims electronically

Aetna Health Insurance is requesting that all medical offices begin submitting secondary claims to them electronically for quicker processing days. If you need help or assistance on how to bill secondary insurance claims follow up with your Practice Management software or your Clearinghouse software depending on who is responsible for this transmission.

Aetna offers a website link to give you additional information on their requirements and it can be found by going to aetna.com/provider/streamline_office.html.

If you submit claims through RelayHealth Clearinghouse they are setup and ready to transmit claims electronically to CPID# 4500 & 6400 Aetna for you.



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Saturday, September 6, 2008

Medical Insurance Carrier Healthlink PPO Edit Update

It has come to my attention that Healthlink PPO at this time is no longer processing secondary claims electronically. Claims need to be dropped to paper and mailed in with the primary EOB attached for processing.

If you bill using RelayHealth Clearinghouse they have added a new edit to make clients aware of these new changes:

EDIT FI version 0001C:Destination Payer must be Primary. In Loop 2000B, SBR01 Must = P
Fix: Change your practice management software to no longer send to this insurance carrier CPID#4448 Healthlink PPO as a secondary claim. At this time Healthlink PPO will only allow primary insurance claims submitted electronically at this time.

Happy Collections!

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