Friday, October 24, 2008

How to start a medical billing service company?

This is a shout out to all medical billers and coders who are ready to break off in the industry and start a medical billing service. Most likely you are currently working for a medical doctor or a billing service right now and figure you can do it better.

That's what happened with me. After working for several medical practices as a biller and collector it became quickly apparent to me that most people have no clue how to run a medical billing service efficiently or effectively.

So, for those who are ready to take the opportunity to grow and may have the medical billing experience but no business experience let me point you to some directions.

  1. www.medicalbillingsoftwarepro.com to research Practice Management Software Products and find the one that will work best for you and your company
  2. www.medicalbillingsoftwarepro.com also has information on Clearinghouses. The clearinghouse is the lifeline of your business. They submit claims electronically (primary and secondary), they notify you almost instantly of any claim denials, the submit your statements electronically, they send you Claim Status reports automatically, they can send collection letters to patients and check their mailing addresses etc. Don't forget eligibility checks.
  3. www.medicalbillingservicepro.com gives you ideas, suggestions and recommendations on how to start, operate and make money with a billing service.
  4. Visit my website often for new updates to coding issues, billing claim denial reasons etc.
  5. http://www.videotrainingpro.com/ offers training videos on Microsoft products like word and excel but they also offer training videos on Practice Management Software. learn how to setup and use a PM software for your own use. This will also help you with your sales demonstrations with your doctors.

Look, if you are tired of working for others and you know you are capable don't wait do it now! If you know you are the cream of the crop and your talents run deep with the medical billing industry doctors are lining up looking for you to work for them. Why not have them pay you to operate your own business.

I get these types of questions all of the time. Can I start a medical billing service? What does it take to operate a billing service? My managers don't seem to know anything - why can't I do it better? How do I create opportunities to own a medical billing service company? What direction should I take to start a medical billing company?

Believe in yourself and don't give up! Trust that you know how to bill and collect and the rest will come to you. You will need to expand your knowledge including contracts, invoices to doctors, signing on doctors but with a well planned out business plan you can do it just like so many others!

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RelayHealth offers direct connection with Humana Veterans Healthcare Services - UB04 claims

RelayHealth has announced a new direct connection for processing electronic claims. This new direct connection is effective for claims submitted on and after October 23, 2008.

CPID#: 5902 Humana Veterans Healthcare Services - Institutional or UB04 claims

RelayHealth has identified the following items to be aware of with this change:

*Payor agreements are not required for electronic claims.

The following payor reports will be available: RelayHealth Standardized Payor Reports.

The following payor-specific edits will be required:
o Edit HU version 0019C:INVALID BILLING PROVIDER ID QUAL ? IN LOOP 2010AA, NM108 MUST BE SENT AND MUST BE EQUAL TO XX


o Edit HU version 0020C:INVALID PAY-TO PROVIDER ID QUAL ? WHEN LOOP 2010AB IS SENT, NM108 MUST BE SENT AND MUST BE EQUAL TO XX

o Edit HU version 0022C:INVALID CLAIM REND PRV ID QUAL - IN LOOP 2310C(INST), NM108 MUST BE SENT AND MUST BE EQUAL TO XX

o Edit HU version 0026C:INVALID CLAIM ATTEND PHY ID QUAL - IN LOOP 2310A(INST), NM108 MUST BE EQUAL TO XX

o Edit HU version 0027C:INVALID CLAIM OPERATE PHY ID QUAL - IN LOOP 2310B(INST), NM108 MUST BE EQUAL TO XX

o Edit HU version 0028D:INVALID SRV LINE REND PRV ID QUAL - IN LOOP 2420C(INST), NM108 MUST BE SENT AND MUST BE EQUAL TO XX

o Edit HU version 0034D:INVALID SRV LINE ATTND PHY ID QUAL - IN LOOP 2420A(INST), NM108 MUST BE EQUAL TO XX

o Edit HU version 0035D:INVALID SRV LINE OPER PHY ID QUAL - IN LOOP 2420B(INST), NM108 MUST BE EQUAL TO XX

o Edit HU version 0052C:INVALID CLAIM SRV FAC ID QUAL - IN LOOP 2310E(INST) NM108 MUST BE SENT & MUST BE EQUAL TO XX


Do you have questions on Electronic Medical Billing and Claims? Then visit: medical claims electronic billing

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First Choice Health Network new electronic claim edits

CPID#'s 6453 and 6554 First Choice Health Network (and this edit may apply to other health insurance carriers) has been added by RelayHealth to notify medical offices of incorrect billing processes that are taking place.

This is happening when claims are being submitted from the Provider to the primary insurance carrier to the secondary insurance carrier through electronic claims transmission. Some people call this Provider-to-Payer-to-Payer or Coordination of Benefits (COB).

When Medicare Part B is the primary insurance carrier and the patient has secondary insurance they are requiring all of this information to be transmitted with the claim so Medicare can forward on to the secondary insurance carrier for you.

EDIT: DZ 0006C:INVALID OTHER INSURED ID - IN LOOP 2320, IF SBR09 = MB, 2330A REF01 CANNOT = SY
Fix: Confirm you have the correct secondary insurance subscriber information for Medicare can adjudicate the claim correctly and facilitate the 837COB transaction. First Choice Health Network does not accept Social Security Numbers

SBR09 = MB stands for Primary Insurance Carrier Medicare Part B
2330 A is Subscriber's secondary insurance information
REF01 CANNOT = SY and SY means Social Security Number

Update the Insurance Carriers Subscriber information with the ID# found on the insurance card and rebill the claim.

To view over 250 articles on Medical Billing and Coding information please check out Medical Billing and Coding Articles

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Cigna Health Plan Claim rejection report edit

Most doctors and medical offices are contracted with Cigna so you can all relate to this new Electronic Claim Exclusion Edit that just came out through RelayHealth. Please be aware of the edit and steps to fix and rebill the claim.

Insurance Carrier: Cigna Health Plans
CPID#: 6405 through RelayHealth
Edit: AM 0007C: INVALID REF F8/CLM FREQ TYPE CODE- IN LOOP 2300, IF CLM05-03 IS NOT 6, 7 OR 8 THERE CAN NOT BE A 2300 REF F8 SEGMENT
Fix: Claim Frequency Numbers need to be indicated when billing claims for corrections, replacements or void requests. The original CRN number needs to be tied to the claim in REF F8 segment in order for the insurance carrier to know which claim you are talking about.

Claim Frequency stands for:

  • 6 is a Correction of a previously submitted claim: You are requesting the insurance carrier to adjust the original claim with your new information.
  • 7 is replacement of Prior Claim: When you use code 7 you are telling the insurance carrier to void out the original claim and the information on this claim represents a complete replacement of the previously billed claim
  • 8 is to Void or Cancel the previously submitted Claim: You are telling the insurance carrier to purge or delete the original claim from it's records in it's entirety.
Reference F8 Segment
Segment REF is the original claim reference number
F8 must be in position 01 (the reference identification qualifier)
the claim number must in position 02

Example: REF*F8*E12345678900

In short when using the 6, 7, or 8 to indicate a correction, replacement or void the insurance carrier requires the original Claim Reference Number (CRN) information. If it is not submitted than Cigna doesn't know which claim to "update" in their records and can not process your request giving you this rejection.

You can get the ICN/DCN or original reference number on your electronic claims report from your Clearinghouse.

Other Recommendations:
Let's say your office billed a claim with the wrong providers information on it. You can resend the original as a Void/Cancel claim (8) using the original CRN. Now that you have officially voided it you can make the changes in your Practice Management software and re-create the claim with the correct provider and bill the claim.

If you do not know where these fields pull from in your Practice Management Software contact your support department for clarification.

Interested in Medical Billing and Coding read more articles on Medical Coding and Billing Courses
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RelayHealth offers an additional Processing Time

The medical industry is about information and time. If you can get the information faster to your office the less time you spend working trying to identify claim issues. The quicker you find claim issues the sooner you can fix and rebill.

RelayHealth understands that time is valuable and because of this they are adding an additional processing time for reports. Currently they generate reports 3x's a day at 4:00 am, Noon and 4:00 pm CT.

They are adding a 4th reports processing time which will be set for 8:00 am CT. Starting November 1st 2008 you will get reports at 4:00 am, 8:00 am, Noon and 4:00 pm CT for the following McKesson/RelayHealth reports:

  1. Payor Batch Totals Report (SB)
  2. Payor Batch Totals Data File (SD)
  3. Payor Claim Data Report (SR)
  4. Payor Claim Rejections Report (SE)
  5. Payor Report Data File (SF)

If you have questions on the differences of the reports please see my earlier blog:

How to Read Clearinghouse Payor Claim Data Reports
Understanding Clearinghouse Medical Reports



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

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Wednesday, October 15, 2008

Vehicle Insurance Coverage Rates: What Makes Them Change?

Auto insurance rates are funny things. You can get free online vehicle insurance quote. There may come a time when an insurance company will offer you a particular rate, yet offer a friend a completely different one. The rates or cost of insurance may change depending on many factors such as individual, location, and company used. Before you purchase an auto insurance policy, it is highly recommended that you compare rates between several companies so you get the best rate possible. Obviously, it's wisest to check for the best deals on automobile coverage.

There are multiple reasons why rates fluctuate. They can go up whenever there is additional risk involved in the insurance policy. The higher of a risk that you pose, the higher your premiums will be to cover that risk. You should read about
online van insurance quote. For example, if someone have gotten into several traffic violations, their insurance rates are likely to go up. The risk has increased recently A young driver who is inexperienced is at a greater risk to have an accident, so the cost for them to repair a vehicle will be higher than that of an experienced driver.

Auto insurance also is dictated by the company. insurance companies offer more benefits to multiple insurance policies Others will offer a 'good student' discount rate. Individuals who have excellent credit scores normally get better rates but there are still good rates for individuals who have good credit scores. Even after that information is established, there are still other things that effect insurance rates offered by insurance companies. This only includes the costs that are charged by the insurance company. other offer lower rates than others

Shopping around for the lowest insurance rates for your auto is essential. You'll find it pays to shop around as some companies offer lower rates for apparently no reason at all! Shop for insurance plans thoroughly enough in order to be able to compare them and avoid high-costing ones. For more
auto and car insurance quotes


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


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Chewers and Alternate Tobacco users still can obtain affordable life insurance!

Life Insurance for people who chew or use snuff!

You might not have know that the major life insurance carriers over the past few years have eased the underwriting restrictions quite a bit on insureds who use alternate tobacco. The carriers have decided that cigarettes have a much higher effect on your mortality over chew, cigars or pipes.

What this means to you is that it is possible to find truly affordable
Chewers Life Insurance, Term and or Permanent Life Insurance coverage that wont break the bank. Alternate tobacco users like chewers, pipe smokers can now find insurance plans from carriers at non tobacco rate classes. Savings can be tremendous if you can obtain a non tobacco rate class.

There are currently a few top rated life insurance carriers that offer great tobacco rates see below

  • AIG may offer at this time Preferred Smoker
  • AXA may offer at this time Preferred Tobacco
  • ING-Reliastar may offer at this time Preferred Smoker
  • John Hancock may offer at this time Standard-Non Tobacco
  • Lincoln may offer at this time Standard-Non
  • Principal may offer at this time Preferred Tobacco
  • Prudential may offer at this time Non-Smoker Plus
  • Transamerica may offer at this time Preferred Smoker


Of course these rate classes are subject to change at any time so please check with your agent or broker for the most up to date rates and quotes.

The best approach when a chewer or alternate tobacco user is looking for quality affordable and in some cases
cheap term life insurance coverage is to either contact your agent or go online and do a search. Call a brokerage agency that has access to at least ten or more top life insurance carriers that are tobacco friendly. The great thing about brokerage agencies is that they have up to minute access to the carriers that offer the best quote and rates. Career Agents mostly represent only one company and they are typically much more expensive with there tobacco rate classes.

One of the best
Term Life Insurance Companies that offers great tobacco rates is Prudential they happen to be one of our favorite carriers when in regards to getting affordable coverage. Over the past few years they have been at the fore front of offering awesome rates for chewers and pipe smokers. It may be well worth your time to get a quote from them.

Remember be candid and upfront when applying for the coverage, if you try to lie the company will most likely find out from a urine sample they take during your paramed exam. Also the company could flat out reject your application if these choose for non candor.


Interested in reading articles onMedical Billing and Coding then check out Medical Coding and Billing Courses

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Monday, October 13, 2008

Chiropractors can you bill CPT 98940 to Medicare using Electronic Claims?

On Monday October 13th 2008 Medicare sent out a notice to Chiropractors about the Alert of how to bill Procedure Code 98940. They identified that someone was incorrectly notifying Chiropractors that procedure code 98940 was not allowed to be submitted electronically. Medicare wants you to know this is incorrect information and to disregard Immediately.

YES, you can bill Procedure Codes 98940, 98941, and 98942 electronically to Medicare Part B. You could do this in the past, now and in the future - don't delay send your claims today.

98940 - Chiropractic Manipulation Treatment (CMT); spinal, one to two regions
98941 - Spinal, three to four regions
98942 - spinal, five regions

I am assuming someone or some group released a publication stating that Medicare does not pay for these CPT codes. They do pay for these medical procedure codes but only if you know how to bill using these CPT codes.

Please view my earlier article(s) if you are new to the Chiropractic medical billing industry or if you are getting medical claim denials from Medicare:


Chiropractic Medical Billing

Chiropractic Medical Billing2

*Another note: Some people don't know this but their Practice Management Software may actually NOT be submitted the Modifiers. Check with the PM software if Medicare is saying the modifiers are not coming through and ask them (billing software vendor) if Chiropractors need to perform any special "extras" in order to get the claim to go electronically with all of the LOOPS filled out correctly..

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


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Thursday, October 9, 2008

Make money in your spare time while working from Home

Are you in between jobs, looking for a job or a housewife just looking to make extra money each month? This is a great way to make "AUTOMATED" monthly income.

This is a online internet program to teach you how to make monthly residual income. It's easy to learn, takes some time initially (all of which can be done around your schedule) and fun to do. When you get your first check you will be hooked and will want to make more each month. Let's show you the steps you can take to get started - TODAY!

I really don't think I need to tell you the beauty of this program. It's work from home, it's around your lifestyle, you can make as much or as little as you want. So let's get into the facts of what it means to make money from home. As soon as you get your affiliate ads (discussed below) added to your website you can start monitoring reports that will show you how many people are visiting your site. This matters because the more people that visit your website the more likely it is someone will click on one of your advertisements. Here are my stats for last month: I am currently averaging about 20 page impressions until somebody clicks on one of my links. Each click earns me an average of $X.XX (normally ranges between $.01 - $4.25 a click). If I drive 25,000 unique page impressions to my website(s) I can earn $X,XXX.XX monthly. This program is simple math = drive more traffic to your website, increase your clicks and make more money. (PS I can't tell you how much I make per click because my contract with affiliate ad companies prohibit this and you will be in the same type of contract once you sign up)

This means in 3 months of learning these steps; if you began clearing $250 a month and decided you wanted to make $500 a month you can double your steps to increase your monthly revenue by either increasing traffic flow to your website or creating additional websites. This is how some people figure out how to make $4000, $5000, $6000 and upwards of $100,000 a month.


This is a low start up program and I am not trying to sell you anything. I am showing step by step exactly what I have done to do this. These are the same companies that I use for my websites and these free tips are to help you get started immediately.

Your initial setup costs about $750 to purchase the Dreamweaver software, pre-created website template and web hosting software but considering you just started a business for under $750 with no overhead for the next 2 years; this is a great deal.


If you just pluck away at this you will find that it’s easy to make $300 a month so over the next 24 months that would equal $7200. However if you put a bit more energy and effort into it you can make over $300 a month netting you bigger profits. Remember this is part time work in the comfort of your own home and no boss to tell you what to do. Teenagers do exceptionally well with this kind of work and since you can make money working at it Part Time this is great money for them.

1. Purchase a 2 year contract for
Professional Web Hosting $6.95 per month
2. Purchase
Adobe Dreamweaver CS4 and training manual
3. Purchase cheap, pre-created website template

4. Use Dreamweaver software to upload your website to the Professional Web Hosting software
5. Sign up with Affiliate Advertisement companies like LinkShare Corporation
6. Submit 2-3 Press Releases a month to drive people to your website

Right now you can complete steps 1 - 3 today to move forward. Select a Domain Name (this is the name of the website like videotrainingpro.com). Try and create a domain name that has your product key words in it. Example: if you are going to sell credit card offers make that part of the website domain name creditcardoffers.com. We don’t recommend using _ - or ‘ in the domain name.

Do follow up research on Backward Links, Page Rank, Press Release, and Affiliate Advertisement programs? The higher the PR (page rank) the higher your website gets indexed so people can find you faster. Backward links are companies that have your website on their website and it is connecting the two increasing your Page Rank. 2 PR articles submitted through Press Release companies about your website, or product will help increase your traffic and Page Rank. Affiliate Advertisement companies like Commission Junction,
LinkShare Corporation, Google, and Amazon will give you products to sell on your website without the headaches of taking support phone calls or dealing with the actual sell of the product.

Affiliate advertisers find companies like Credit Card companies who wants to advertise their services on websites. They sign a contract with these Affiliate companies saying they will pay on a per click or per sell price range. Affiliates put these offers on their website and you can choose which companies you want to promote on your website. Your job is to add these banners to your website and drive traffic to actually click on this logo, banner or text. Some are a Cost Per Click (CPC) program while others will only pay you commissions if your traffic buys a product from them.

Every 30 days you, if you have made commissions you will receive a check. Start today adding cash to your checking account. If you get stuck and need help submit a comment with your contact information. I will not release the comment but will follow up with you by email. If you just want to comment or add to this please submit away and I will release it be read by all.


Interested in Medical Billing and Coding read more articles on Medical Coding and Billing Courses


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Wednesday, October 8, 2008

Make over $500 for Part Time work from Home

Would you be interested in learning ways to make extra money working from home? If you are looking for additional monthly income that to either one day retire early, or just pay down some bills you may have stumbled across the most exciting idea ever. You can make automated monthly residual income from the comforts of your home without any boss. You will be your own boss!

With very little start up cash (under $750.00) and some time you can begin netting over $300 a month in residual income. Our steps are the same ones we take to make automated monthly residual. Our business now manages over 12 websites and what I am about to teach you we learned almost 2 years ago.

This is a highly effective method to make money online from home. With a bit of research you will find it's the lifeline to how people are making money online. Because it's such a low cost setup more and more people can afford this and the great thing is their is plenty of money for all. Companies need/want you to advertise for them and you want to make your website profitable. It's a win-win situation for all parties.

1. Purchase a 2 year contract for
Professional Web Hosting $6.95 per month
2. Purchase Adobe Dreamweaver CS4 and training manual
3. Purchase cheap, pre-created website template

4. Use Dreamweaver software (step 2) to upload your website including webpages to the hosting software (step 1)

5. Sign up with Affiliate Advertisement companies like LinkShare Corporation

6. Create about 2-3 PR articles and submit to Press Release companies monthly to Drive More Traffic To Your Site

Dreamweaver software and training manual costs about $425. This is the bulk of your costs and to keep your website prices low it's best you master Dreamweaver. You will spend about $170.00 for your domain name (website name like http://www.videotrainingpro.com/) and hosting software for a 2 year contract. Pre-created website Templates can range between $45 - $75 (Dreamweaver allows you to add your text, logos and Affiliate Ads to these templates). Essentially you just started a business for under $750.00. If you decide to create additional websites you can roll out the next one for under $225.00.

If each website you own makes $300.00 - $500.00 a month with just a little work you can make roughly $3600 - $6000.00 for each website per year. It cost you only $750.00 initially to start this business and you can have your initial costs paid for within 3 months. Over the next two years you will clear $6300 worth of profits (remember hosting company is a 2 year contract). If you want to make more monthly income create more webpages (adds depth to your website), or additional websites with different subject matter.
Right now at this very minute you can proceed with steps 1-3 by purchasing the hosting software to secure your website domain name, order the Dreamweaver software and buy the website template. The hosting software offers online training tutorials that you can begin watching immediately and the template can also be downloaded immediately. They also offer support and training materials on HTML code and web pages.
While you are waiting for your Dreamweaver to come in the mail sit down and prepare your text you want to add to your webpages. Think about the type of traffic (people) you watn to visit your website and what would they be interested in reading about?
Once the Dreamweaver software and training manual arrive in the mail you can begin programming your website template. If you have questions refer back to your Dreamweaver training manual and check things out on the Internet. As most people before you will have had the same questions and the results can be found in most Adobe forums.
Once the website is uploaded to the hosting software you are ready to register with affiliate programs like commission junction, Link Share or Amazon. At this point I would highly recommend you start with Amazon first because you will find that they have easy to create online store websites that you can just drop the code into your website and see the products appear on your website.

Once you have the website created (and that is the hardest part) you need to drive traffic to your website. The best known way is through press releases as discussed in step 6. Write about 350 words (called a article) and discuss your product or service. Include links to your website a few times within the article and add them to Press release companies that can be found online. If they like the Press Release they will advertise it on the Internet and this Drive More Traffic To Your Site.

Take some time to study Backward Links, Page Rank, and using key words so people can find you using words that can search for your website.

Each month you will receive direct deposit from your affiliate companies that you have registered with. The more traffic you direct to them the more money you make.

Want to see my newest project? Visit: http://www.medicalbillingservicepro.com/ and see how the suggestions above are being put to work.




Interested in Medical Billing and Coding read more articles on Medical Coding and Billing Courses

Monday, October 6, 2008

Doctor Promotional Giveaways to increase patient business

Doctors are always looking for new ways to promote their business to people in the area. Recently I was in the office of a orthodontist. He offered "business" shirts with catchy sayings to all new patients that came to his office.


To find products for the ideas listed in this blog visit: 30% to 60% OFF All Products

Another office offered magnets with their office logo, name, phone number, email and fax information.

Another office sends out creative cards 2x's a year just to say Thank You! It reminds patients that they have a friend with the doctor.

One office gave out Car Door Magnets. It had catchy phrases on it like "My doctor is cuter than your doctor" or Dr. XYZ is the best doctor in SLC, UT.

One office has created window decals that they put on their own windows, doors and hand out to patients that want to add them to their car windows.

One office gives a calendar for the whole year to each patient. Each month it has a picture of the office group etc.

Find a product that best suits your medical business needs. Guaranteed lowest prices and satisfaction! Enjoy getting promoted by your patients as they enjoy the free goodies!


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

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Looking for Health Insurance Carriers to Compete for your Business

Holladay, UT October 6, 2008 - Working for medical providers I find that most small doctor offices do not carry health insurance coverage for their employees. They feel it's an extra cost that they can't afford and if their employees get sick they can treat them for free.

This is great for most single, young employees however; married employees who are planning on having children and not wanting to stress about health insurance feel left out and normally can’t afford to work with small businesses.

If you are at a time in your life that you are looking for Health Insurance Rates check out
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Find a Health insurance plan with reputable companies like Aetna, Cigna, Humana, Oxford, and Blue Cross Blue Shield. Never again worry about what might happen when you can feel safe knowing it’s covered.


For more articles about Medical Billing and Coding read this Over 250 Medical Billing and Coding Articles

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Saturday, October 4, 2008

Medical Coding, 2009 ICD-9, 2009 CPT medical billing books

It's time to purchase the 2009 ICD-9, CPT and HCPCS AMA (American Medical Association) medical coding and billing books.

If you are a billing service or a medical practice you want to make sure you have the most up to date books for coding and billing purposes. Do not delay to familiarize yourself with all codes that are new, changed or deleted.



All purchase orders of $25 or over include free shipping. Also, you will find books at discounted prices making it affordable for all practices to purchase.

2009 Coding and Billing for Ophthalmology
2009 Coding Guide Ophthalmology
2009 Coding and Billing for Physical Therapy/Physical Medicine
2009 Coding Guide Anesthesia
2009 Coding and Billing for Radiology
2009 Coding and Billing for Oncology/Hematology
2009 Coding and Billing for Orthopaedics, Lower
2009 Coding Crosswalks for Laboratory/Pathology Services
ICD-9 CM Coding 2009 Edition
2009 Coding Guide Obstetrics/Gynecology
2009 Coding Guide Physical Medicine Services
Medical Insurance Coding 2009-2010
2009 Coding Crosswalks for Surgery Services
ICD-9 Coding Guidelines for Home Care
National Correct Coding Manual 2009: Comprehensive Guide to Medicare Ncci Unbundling Errors 15.0
Physicians Fee and Coding Guide 2009
2009 Coding and Billing for Cardiology/Vascular Surgery
2009 Coding and Billing for Behavioral Health
2009 Coding and Billing for ENT/Allergy/Pulmonology
and so much more...


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


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Friday, October 3, 2008

Iowa Blue Cross Blue Shield and South Dakota BCBS new claim submission updates

If you are billing any claims electronically through a clearinghouse or direct connection to Iowa Blue Cross Blue Shield and South Dakota Blue Cross Blue Shield please be aware they are requiring as of November 15, 2008 to submit National Provider Identifiers (NPI) only.

If you submit claims with the legacy number, Wellmark provider number, will be rejected and only accepted once the NPI only is submitted.

If you have never enrolled with Wellmark you must complete the EDI to submit claims using the NPI. To enroll with Wellmark visit wellmark.com and click on Providers > Enrollment > Iowa or South Dakota.

If you are using RelayHealth as your clearinghouse you will use CPID# 1404/1510 for Iowa BCBS and CPID# 2490 South Dakota BCBS.

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

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Wednesday, October 1, 2008

Care Choices gets a new Payor ID Number

For those clients who use RelayHealth and currently bill to Care Choices/Preferred Choices please be aware of new CPID#'s to bill electronic claims with.

Existing: 2755 and 3595 Care Choices/Preferred Choices
Payor ID# 38269

Consolidate and bill to now: 7459 and 3591 Priority Health of Michigan
Payor ID# 38217

From October 1st - October 30th RelayHealth will convert CPID#2755 and 3595 into 7459/3591 for you automatically. On October 31st 2008 you will receive claim denials from RelayHealth if you have not updated the new CPID#'s.

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