Ask A Medical Biller

Microsoft Office Training Videos

2010-05-28T08:51:00.001-07:00

These are the best Microsoft Office Training Packages. They are all completed by a Certified Microsoft Office Trainer who is certified in Microsoft Applications. Get these highly detailed training for you and your medical office.

Use Word to create Letters, Patient Documents, Templates, Fax Sheets, Mailing Labels, and patient forms.

Use Excel to manage Accounts Receivable, create graphs, track business numbers.

Use Powerpoint to create marketing materials and presentations for conferences, talks, and onsite visits. It's also a powerful tool for medical billing services that are presenting their services and skills to new clients.

Professional Liability Errors and Omissions Insurance for Medical Billing Services

2009-05-06T08:52:00.000-07:00

Do medical billing services, individual medical billers and certified coders require Professional Liability Errors and Omissions Insurance coverage to perform their job duties?

Professional Liability Errors and Omissions Insurance coverage helps to protect your business or company services from claims submitted by your clients.

Let's say you are a medical billing service and the doctor sends you $120,000 worth of Aetna medical claims. You are required to bill a clean CMS 1500 claim to Aetna within 90 days from the date of service (per doctors contract with Aetna) and you have issues getting a clean CMS 1500 medical claim sent through the electronic medical claim clearinghouse software. Your medical billing staff didn't realize they could drop the claims to a CMS 1500 form and bill it by paper so the claims sit their denied at the medical claim clearinghouse, waiting for someone to fix the issue.

95 days later you finally get the medical claim clearinghouse working and all CMS 1500 electronic claims are submitted to the carrier and denied for untimely filing. Your billing service can't appeal (although it doesn't hurt to try) because you can't prove you sent Aetna Health Insurance a clean CMS 1500 medical claim in the timely filing period.

Now let's say the doctor was expecting to collect about $73,000.00 from Aetna on the $120,000 worth of medical claims. The doctor is mad when he finds out that he just lost $73,000.00 in business and decides to sue you for this loss.

The Professional Liability Errors and Omissions Insurance Coverage can potentially protect you from most of these fees including court, attorney and lawsuit settlement fees.

Does a Medical Billing Service require Professional Liability Errors and Omissions Insurance - no but would it help out to cover the costs of protecting your business in the case of being sued by a doctor? Yes.

Who needs Professional Liability Errors and Omission Insurance in the medical industry? Anyone who performs "services" to a client. Services can be anything from billing, coding, doing work in a "timely" matter.

General Liability Insurance does not protect your business for errors, contract performance disputes, or any other professional liability issues which is why they have Error and Omission insurance.

Other Medical Insurance Policies

Medical Malpractice & Medical Liability Insurance covers providers and other professionals in the medical industry for liability claims arising from their treatment of patients. Pricing varies by the rendering providers specialty, location and state.
Some states do not require providers to have Medical Malpractice Insurance although most doctors do have Medical Malpractice Insurance.

Employment Practices Liability Insurance or EPLI insurance is insurance policies to protect employers from employees, former employees or "potential" employees. If employees feel discriminated against for their age, sex, race, disabilities, sexual harassment or wrongful termination you may find the need for EPLI insurance.

Keywords: Medical Billing Insurance, Certified Coders insurance, Insurance polices for medical offices, insurance policies for medical billing services, when to buy, do I need to buy, purchase, insurance policies, medical industry, medical billing companies, corporations, businesses, employed, employer, small businesses, health care, providers, doctors, nurses, assistants, biller, collector, collecting, collections, doctor error, erroneous,

How does a Medical Office gain insight into what their Medical Billing Service is doing with Medical Claims?

2009-02-16T10:39:00.000-08:00

A medical office is outsourcing their claim billing to a medical billing service. The medical office has no transparency into what is happening with their medical claims and they were asking me what steps they should take to gain access to the billing services electronic medical claim clearinghouse Office Ally.

The Medical Office's concerns are the lack of insight into all electronic claims, which claims are getting submitted, are any kicking out, if they are getting claim denials what are the reasons, how often is the medical billing service actually billing their medical claims, and what percentage of claims are getting passed on to the health insurance carrier? Because of these concerns they want access to the electronic claims clearinghouse.

Let's first review how the medical claims clearinghouse Office Ally works?

All data is entered into the Practice Management/Billing Software

A claim file is generated

The claim file is downloaded to the desktop

The user logs into Office Ally
The user uploads the claim file from the desktop into Office Ally Clearinghouse Software
The user submits these claims electronically through Office Ally after it passes through certain claim edits
Any denied claims will be received in a report format, the medical billing service should be fixing the issues in both the claim clearinghouse software and in their Practice Management Software
The medical billing service should be permanently deleting the Claim File from their desktop to remain HIPAA compliant

If the medical billing service has the contract with Office Ally Clearinghouse and you are the medical office contacting them to gain access they will most likely forward you on to your medical billing service to get a user name/password. Office Ally Medical Claim Clearinghouses contract is with the billing service and not you.

If you are not on speaking terms with your medical billing service or you would rather they not know you are trying to log into Office Ally Clearinghouse than you will need to work this through another angle.

Your other option and one that you have more control over if you cannot get a user name and password into Office Ally's Clearinghouse.

The doctor has access to setting up user names/passwords with all health insurance carriers they are contracted with including BCBS, Cigna, Aetna, UHC, Humana and many more. This is the same place that you might use to check patient eligibility online but instead of clicking on the eligibility click on the claim status section.

Side Note: If the billing service has registered the doctors on these websites you will need to ask them to give you user names/passwords to access. If they ask why you need access (and they shouldn't but if they do) explain the doctor would like to monitor new coding updates, releases, fee schedules and that the front office needs access to check patients eligibility and pre-authorizations. Notify the billing service that you would like them to keep you updated with the most current user names/passwords for each health insurance carrier.

How to use your Health Insurance Carriers websites to track what your billing service is doing?

Use the online claim status screens to track your patients and identify how long it takes from the time you give the claims, medical records information to your billing service until it gets accepted by your health insurance carrier. Plus you can check for denials etc. If the patients claims are not on file with the health insurance carrier than it means that the billing service is having issues submitting claims through Office Ally (they are kicked out because information is being sent incorrectly so they do not send on to the Health Insurance Carrier).

For a list of additional Articles I have written please check out this website and scroll down until you get to the Electronic Medical Billing Clearinghouses section.

Medicaid of Illinois is requiring doctors to register NPI numbers

2009-01-16T08:05:00.000-08:00

Medicaid of Illinois Health Insurance currently requires providers to report a one digit payee code in the Billing or Pay-To-Provider Loops. This one digit payee code designates the appropriate Pay-To-Provider.

Illinois Medicaid is now requiring medical providers to register their NPI numbers associated with their designated Payee ID's. They will soon be transferring their software to accept the NPI number in lieu of the 1 digit payee code.

If you are a medical provider and bill to Medicaid of Illinois Health Insurance you should immediately register your NPI number for each designated payee number. You can register the NPI number at either website:

myhfs.illinois.gov
illinoisnpi.com

After the NPI information is registered with the HFS, the Payee NPI can be reported in the 837 (electronic medical claims) and DDE transactions. Also, after the NPI number has been registered you can start billing your medical claims using the NPI number and the 1 digit Payee ID will no longer be required.

The deadline for registering and using the NPI number is March 1, 2009. Any claims submitted electronically not using the NPI number will be rejected.

Register now to prepare for these changes by March 1, 2009.

Medical Billing and Coding Tags: Medical Health Insurance, Medicaid of Illinois Health Insurance, Medicaid NPI updates, Medicaid Payee one digit updates, New change over, New Medicaid of Illinois deadlines, Electronic Claim Denials for invaid NPI number, update, switch over, electronic

Oregon Medicaid MMIS Updates on Claim and ERA issues

2009-01-16T07:54:00.000-08:00

Oregon Medicaid Health Insurance was recently converted to a new MMIS system and the bugs have already started to reveal themselves. Oregon Medicaid Health Insurance has identified issues with the Electronic Remittance Advice and some claim processing issues.

Some medical offices and hospitals are experiencing problems with inconsistent denial codes, medical claims dropping out of the system, missing electronic remittance advice and problems with weekly electronic funds transfers.

The transition to the new MMIS system happened in Mid-December. If this is happening to you please be aware that Medicaid is aware of most problems and are working to resolve these issues. If you feel your issue is new please contact Medicaid and notify them of the problem.

Medical Tags: Clearinghouse, Medicaid of Oregon, Health insurance claims billing issues, Electronic Remittance Advice issues, medical claims billing and coding issues

Will United States of America ever get Universal Health Care?

2009-01-09T14:35:00.001-08:00

Universal Health Care is how the government likes to describe a Socialist environment where all Americans would get FREE Health care including illegal aliens. (Oh I forgot Illegal Aliens already get free health care).

The media loves the concept of Free Health Care and anytime a democrat talks about free health care they rave and talk it up in hopes to gain favor amongst the Americans. However States have tried this on several attempts and not one has ever worked (TennCare (bankrupted hospitals, doctor practices and the state of Tennessee, Hillary Clintons Single-Payer plan (pilot was TennCare), Hawaii Universal Health Care for all children lasted 7 months due to unsufficient funds, San Francisco Medicare for All program was voted down even by democrats because they knew it would bankrupt the City). It's mainly the democrats who attempt to push this jargon on the Amercians with the dream of getting free health insurance. What they don't tell you is that since the government would own the doctors they would also own the right of who got to see them.

Of course something else the democrats don't tell you is that the government can't actually afford to pay the doctors equal or more of what they are currently earning so the middle tier and BEST doctors will leave their practice and do something else.

I found this hilarious You Tube video about what the world would look like if America were to socialize the medical industry. All I can say is thank goodness for Google.

If the video didn't make it clear to you try thinking back to your days at Public High School. How many teachers did you feel were actually qualified to cross-teach you. And of those teachers how many did you actually like listening to. Now think about this with doctors. How many doctors on Government Pay Scales do you think will be good at their jobs?

Let me know what you think about Socializing Health Care or I mean Universal Health Care. As a medical biller how do you think this would affect your job? Do you think you would even have a job as a biller if the government ran the medical industry?

Medical Tags: Socializing Health Care, Doctors, Providers, Physicians, Universal Health Care, Single Payer, Mandated Insurance, Hospitals, Health Care Insurance,

Utah Health Information Network (UHIN) to raise electronic fees

2008-12-23T17:41:00.000-08:00

If you are a medical billing service or are a medical provider in the state of Utah and you are credentialed with UHIN (Utah Health Information Network) please be advised that they are raising their per transaction surcharge from $0.12 to $0.168 effective January 1, 2009.

If you submit claims using RelayHealth please be aware that they will pass this fee onto the providers as it is currently in place at this time.

The health insurance carriers that this affects:

CPID 1536 Altius Health Plan
CPID 4726 Altius Health Plan
CPID 4728 Deseret Mutual Benefits Association
CPID 4410 Educators's Mutual Insurance Association
CPID 4480 SelectHealth
CPID 4727 Public Employee Health Program (PEHP)
CPID 1529 Utah Blue Cross
CPID 1530 Utah Blue Cross FEP
CPID 2412 Utah Blue Shield
CPID 2788 Utah Blue Shield FEP
CPID 1486 Utah Medicaid
Please be aware of these changes when you are looking at your 2009 invoices.

Medical Billing Tags: medical billing claims, claim coding, health insurance carriers, medical claims processing, medical claims clearinghouse, medical claim billing and coding, medical billing and coding, new updates, Electronic modifications, new changes to electronic claims submission, aware of New Years updates

Aetna Health Insurance Electronic Remittance Advice Updates

2008-12-23T16:42:00.000-08:00

For all medical offices that bill to Aetna Health Insurance please be aware of their new announcement regarding electronic remittance advice.

Starting March 30, 2009 Aetna will not send Electronic Remittance Advice (ERA's) to providers subject to the National Provider Identifier regulations when

1. A billing provider NPI is not sent on the claim and

2. we have not been notified of a specific override NPI to use on ERA's and

3. the payee does not have a default NPI recorded in Aetna's health insurance providers records

If Aetna Health Insurance does not have a NPI or they adjudicate or reprocess a claim that was submitted without a Billing Provider NPI you will receive the explanation of benefits by paper.

At this time your medical office or billing service maybe submitting medical claims without submitting the NPI number. Right now Aetna health insurance will send your Explanation of Benefits using the Electronic Remittance Advice if it is currently enabled. But on March 30, 2009 those same medical claims will no longer be eligible for electronic remittance advice until you submit the Billing Provider NPI.

If you would like to ask Aetna Health Insurance to continue to receive the payee NPI loaded in to the Aetna Health Insurance system you may send Aetna a email request to their dedicated mailbox aetnanpiera@aetna.com.

Aetna health insurance will be looking for NPI's at the Payee ID source, Group ID source and/or the Rendering Provider ID Source.

The TIN and provider business group (PBG) will always be sent to identify the taxpayer ID that will be used for IRS reporting and the provider business area handling remittances for the claim.

If you have access to Aetna Health Insurance's Secure Provider Website you can access the NPI's assigned to your provider if you have registered for the ERA/EFT feature.

Please be aware of these new updates and confirm that you are submitting the NPI numbers now so you will not see a issue with your Explanation of Benefits. Waiting on paper EOB's can become extra work for any billing department when identifying paid/unpaid claims and the status of such.

For those who bill using RelayHealth: Aetna Health Insurance CPID#'s are 4500 and 6400. If you are new to billing or are interested in learning more about medical claims reports please visit: Medical Claims Clearinghouse Reports

Medical Billing Tags: medical claims clearinghouse, electronic medical claims clearinghouse, medical billing and coding, new ERA updates, new changes, reviews, reporting, Health Insurances, medical billing, medical billing, claims coding and billing, medical claims, claim submission, claim billing, healthy medical claims, clean claims submission, faster payments on insurance claims, health insurance billing and coding

Oregon Medicaid MMIS Updates

2008-12-23T09:15:00.000-08:00

On December 11, 2008 RelayHealth, a medical claims clearinghouse, began submitting electronic claims to Oregon Medicaid Health Insurance Carrier (CPID#1481 and 5517).

RelayHealth, a medical claims clearinghouse, is adding new claim edits that you should be aware of if you bill to Oregon Medicaid Health Insurance.

The following apply for Professional CPID 1481:

Professional claims are CMS-1500 formatted claims to indicate the providers services:
HU 0019C:INVALID BILLING PROVIDER ID QUAL - IN LOOP 2010AA, NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU 0022C:INVALID CLAIM REND PRV ID QUAL - IN LOOP 2310B(PROF)/2310C(INST), NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU 0028D:INVALID SRV LINE REND PRV ID QUAL - IN LOOP 2420A(PROF)/2420C(INST), NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU 0031D:INVALID SRV LINE SUP PROV ID QUAL - IN LOOP 2420D(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX
HU 0043C:INVALID CLAIM REF PROV ID QUAL - IN LOOP 2310A(PROF) NM108 MUST BE SENT & MUST BE EQUAL TO XX

The following apply for Institutional CPID 5517:

Institutional Claims are UB-04 and indicate facility charges
HU 0019C:INVALID BILLING PROVIDER ID QUAL - IN LOOP 2010AA, NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU 0020C:INVALID PAY-TO PROVIDER ID QUAL - WHEN LOOP 2010AB IS SENT, NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU 0022C:INVALID CLAIM REND PRV ID QUAL - INVALID CLAIM REND PRV ID QUAL: IN LOOP 2310B(PROF)/2310C(INST), NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU 0024C:INVALID CLAIM SRV FAC ID QUAL - IN LOOP 2310D(PROF)/2310E(INST), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX
HU 0026C:INVALID CLAIM ATTEND PHY ID QUAL - IN LOOP 2310A(INST), NM108 MUST BE EQUAL TO XX
HU 0027C:INVALID CLAIM OPERATE PHY ID QUAL - IN LOOP 2310B(INST), NM108 MUST BE EQUAL TO XX
HU 0034C:INVALID SRV LINE ATTND PHY ID QUAL - IN LOOP 2420A(INST), NM108 MUST BE EQUAL TO XX

Please be aware of the NPI updates when billing electronic medical claims.

Want to read additional information on Medical Claims Clearinghouse?

Medical Billing Tags: Electronic Medical Claims, Medical Claims billing, billing electronic claims, electronic claim submission, medical claims clearinghouse, electronic claims clearinghouse, how to bill claims electronically, why bill claims electronically, supporting electronic claims, asking, ask, transmit, rebill, bill, excluded, denied, denials, exclusions, denial edits, how to fix, how to work, how to bill electronic claims through a clearinghouse,

Harrington Benefit Services of OK new claims processing center

2008-12-23T08:55:00.000-08:00

the Medical Claims Processing for Health Choice, Department of Rehab Services (DRS) and the Department of Corrections (DOC) providers are being transitioned over to a new medical claims processor effective January 1, 2009.

If you are a medical provider and you are currently submitting electronic claims to your medical claims clearinghouse please be aware of the new payor ID 22521.

Payor ID# 59142 has been deleted as of December 23, 2008 which correlates to RelayHealth's medical claims clearinghouse CPID#'s:
CPID# 1751 Harrington Benefit Services of Oklahoma Professional CMS-1500 Claims CPID# 2554 Harrington Benefit Services of Oklahoma Institutional UB-04 claims

If you use RelayHealth as your medical claims clearinghouse has not identified the new CPID# that they will use to accept electronic medical claims. They are asking that medical providers hold their medical health insurance claims until the new payor ID is created.

Another reminder is that Health Choice providers will need to send their medical practice location in loop 2010AA REF01 with the LU qualifier. The practice location code is a 6 digit code which is assigned by the HealthChoice Provider Relations Division and they can be called at 800-543-6044.

Read more articles on Medical billing and Coding

Medical Billing Tags: Harrington Benefit Services of OK, medical claims clearinghouse, medical claims processing, medical billing, medical health insurance claims, claim billing, medical coding and billing, asking, ask, choosing, selecting, using, billing, health care, health insurance, processing, producing, electronic claims billing, electronic health,

RelayHealth Medical Claims Clearinghouse has Report Update

2008-12-23T08:25:00.000-08:00

RelayHealth a Medical Claims Clearinghouse has announced that on January 8 2008 they will be modifying the way you look at their medical claims clearinghouse reports.

Health Insurance Carriers return two reports to RelayHealth, medical claims clearinghouse. One report is the Print Image File also known as Availity Electronic Batch Report and the second report is the Data File or Availity Data File. Both of these reports contain duplicate data but the report formats are different.

RelayHealth is trying to streamline the data the their clients get so on January 8th 2008 they will no longer be parsing the Data File (Availity Data File) to clients.

You will still have access to the Payor Claim Data Report (SR), Payor Claim Rejections Report (SE), and Payor Report Data File (SF).

These changes will affect health insurance carriers like:
CPID 1403 Oklahoma Blue Shield
CPID 1405 Illinois Blue Shield
CPID 1406 Texas Blue Shield
CPID 1414 Florida Blue Shield
CPID 1514 Oklahoma Blue Cross
CPID 1563 Illinois Medicaid
CPID 1997 Washington Regence Blue Cross
CPID 2404 Oregon Blue Shield
CPID 2440 Ohio Choicecare HMO
CPID 2449 Humana
CPID 2488 Illinois Medicaid
CPID 3417 Florida Healthy Options HMO
CPID 3517 Florida Blue Cross
CPID 3540 Idaho Blue Shield Regence
CPID 3561 Florida Health Options
CPID 3890 Humana Encounters
CPID 4544 Humana
CPID 5501 Texas Blue Cross
CPID 5508 Illinois Blue Cross
CPID 5516 Oregon Blue Cross
CPID 5565 New Mexico Blue Cross
CPID 7403 New Mexico Blue Shield
CPID 7426 Idaho Blue Shield Regence
CPID 7451 Washington Regence Blue Shield
and more...

If you use RelayHealth as your electronic medical claims clearinghouse please be aware of these new changes. Tell the medical billers in your office that on January 8 2008 the Data File report will no longer be available for the majority of health insurance carriers but since this report contained duplicate content you should just notice less reports to have to sort through.

Happy Billing!

Read here for additional medical claims exclusion articles Medical Claims Clearinghouse

Medical Billing Tags: Medical claims clearinghouse processing center, medical claims processing, electronic medical claims, medical billing and claims, billing and coding, medical claims clearinghouse updates, reports, news, features, help, what's new, what to expect, changes in the industry, features, health insurance carriers, medical claims,

CDPHP Health Insurance Carrier offers new claim exclusion reasons

2008-12-23T08:06:00.000-08:00

As of December 19th 2008 RelayHealth a medical claims clearinghouse facility will be implementing new claim exclusion edits for CPID#'s 3786 and 2987 because the NPI is now required from the health insurance carrier.

CAPITAL DISTRICT PHYSICIANS HEALTH PLAN (CDPHP)

The following payor edits are for institutional or UB-92 / UB04 facility billing

CPID 2987 - CDPHP:
HU:0019C:

INVALID BILLING PROVIDER ID QUAL - IN LOOP 2010AA, NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU0020C:

INVALID PAY-TO PROVIDER NPI - IN LOOP 2010AB, NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU0026C:

INVALID CLAIM ATTENDING PHY NPI - IN LOOP 2310A(INST), NM108 MUST BE SENT AND MUST BE EQUAL TO XX

The following payor edits are for professional CPID 3786 or CMS-1500 provider services CDPHP:
HU:0019C:

INVALID BILLING PROVIDER ID QUAL - IN LOOP 2010AA, NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU0020C:

INVALID PAY-TO PROVIDER NPI - IN LOOP 2010AB, NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU0022C:

INVALID CLAIM RENDERING PROVIDER NPI - IN LOOP 2310B(PROF), NM108 MUST BE SENT AND MUST BE EQUAL TO XX
HU0021C:

IN LOOP 2310A(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO 'XX'

To fix if you get any of these medical claim exclusions is to add the correct NPI number in the appropriate field before submitting medical claims electronically.

To read additional posts on medical billing please see: Asking a Medical Biller

Medical Billing Tags: asking, ask, search, medical billing and coding questions, how to get electronic claims submitted, medical billings, billing and coding, NPI required, how to fix exclusions, edits, medical claims denials, medical claims billing, health care industry, health care insurance, medical claims, health insurance claims, health insurance billing, electronic claim submission, electronic claim denials, electronic claim how to fix, electronic claim how to bill correctly, billing industry, billing help, tips, tricks, ideas, suggestions, identify, educate, simplify,

How to use Medicare Part B Electronic Data Interchange (EDI) Hotline

2008-12-13T14:40:00.000-08:00

A few years ago Medicare Health Insurance began requesting medical offices to submit all Medicare Health Insurance claims electronically to save processing costs. In order to handle the connection of software products to Medicare they created a department called the Electronic Data Interchange or EDI.

The EDI department has the right to kick out a claim before it comes through their claim processing system. If a medical claim is kicked out at the EDI level it is like the insurance carrier never received the medical claim in the first place.

If you have issues where you are sending Medicare Health Insurance claims and they are not appearing in the IVR or in the support line it means one of two things:

1. Your clearinghouse kicked out the claim for issues
2. The Medicare EDI department kicked out the claim for issues

I would first recommend viewing your EDI reports for the patient that Medicare Support was not able to find on file. Now that you have the report read the exclusion reason...

If you don't understand the denial reason you have 3 different options depending on how you are submitting the claim:

1. If you use a Practice Management software that is integrated with the medical claims clearinghouse you might want to contact them first to see how to resolve the issue.
2. If you use a Practice Management Software that is not integrated with the medical claims clearinghouse and you can contact your medical claims clearinghouse do so now. Ask them to pull the file and see why they can identify the claim is getting kicked out.
3. If you have a direct connection with Medicare Health Insurance follow the EDI Hotline Rules

To make a phone call to the EDI Hotline please have this information handy:
1. Submitter ID number. It can also be called Sender ID, User ID and/or Billing Location Code for providers sending to Medicare Health Insurance through Blue Cross of Michigan.

2. NPI number (National Provider Identifier) and can be found in the NPPES directory

3. Date you submitted the claim

4. Processed Date if report states "deleted"

Do not call Medicare's EDI Hotline until you have prepared all of this information. They are usually very nice in the EDI department but they are in a hurry so they need this information quickly.

EDI Hotline for Medicare Part Health Insurance Carriers: 877-567-7261

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

Medical Billing Insurance Tags: Medicare Health Insurance, Health Insurance Claims processing, Medical Claims Billing, Medical Health Insurance Claims, Electronic Claim Submission, EDI Hotline for Medicare Part B, How to fix denials for Medicare, Deleted Files on EDI Reports, How to work EDI Denial Reports, EDI Denial options, Medical Billing, Medical Billing and Coding, Medical Coding,

Sagamore Health Network moves to new location

2008-12-13T14:29:00.000-08:00

RelayHealth was updated with a new physical address for Sagamore Health Network.

The new location is:
Sagamore Health Network
11595 North Meridian Street
Ste #600
Carmel, IN 46032
800-933-3466

Sagamore Health Network will have the servers down during this transition and will not be able to process electronic claims during Friday December 12th 2008 - Monday December 15th 2008. RelayHealth will submit files to Sagamore Health Network up to December 11th 2008 and resubmit to Sagamore on December 15th 2008 after 8:00 am ET.

Clients do not need to stop submitting claims to RelayHealth as RelayHealth will just hold the Sagamore claims and process them the next week to Sagamore. Please be aware of the delay for claims submission and claims reporting.

Also please update your records with the new physical location.

Medical Billing Tags: Indiana, Sagamore Health Network, Medical Billing, Medical Billing and Collections, Medical billings, Medical Health Insurance claim filling,

Present on Admission (POA) for Institutional Medical Claims (UB-04)

2008-12-13T14:18:00.000-08:00

Starting December 30, 2008 RelayHealth medical claims clearinghouse will print the Present on Admission (POA) indicator for institutional paper claims that are submitted through RelayHealth (electronic file sent to RelayHealth and RelayHealth drops claim to paper).

CMS was the first to require the POA but RelayHealth wants to open this up and make it available for institutional medical claims to submit these to other insurance carriers as needed.

When dropping Institutional Claims to Paper through RelayHealth please use these CPID#'s:
4350 ~ Commercial
4352 ~ Medicaid
4353 ~ Blue Shield
4354 ~ Commercial Carrier Direct
Reporting Options to indicate POA (Present on Admission)
Y = Yes, was present at the time of inpatient admission
N = No, was not present at the time of inpatient admission
U = Unknown, documentation is insufficient to determine if condition is present on admission
W = Clinically undetermined provider is unable to clinically determine whether condition was present on admission or not
Unreported/Not used (exempt from POA reporting)

Medical Billing Tag Words: Medical Billing Health Insurance Claims, Medical Billing Hospital Facilities, Medical billing and Coding, Medical Billing and Collections, Coding, Reporting, Present on Admission, POA, ICD-9 codes, when to use POA, updates to POA

Ask a Medical Biller Index

2008-12-08T12:54:00.000-08:00

Sometimes accessing blog articles can be difficult for the user. I am creating a Master Page or SiteMap for ease of navigating to over 258 articles in specific categories.

You are visiting this Website URL: http://www.askamedicalbiller.blogspot.com/

These are additional blog posts that you can read while on Ask A Medical Biller.

Medical Billing and Coding Courses Information

Telehealth Online Medical Billing and Coding Courses
Present on Admission for medical claims clearinghouse
Medical Billing and Coding for Evaluation and Management
Ophthalmology medical billing
Modifier Billing
Anesthesia Medical Billing and Coding
Electronic Medical Claims Secondary
Medical Billing Coding for Allergies and Sinuses
Medical Billing Taxonomy Code text
Wisconsin Physician Service Website update
Medical Billing Place of Service
Electronic Medical Billing for Claim Adjustment Reason Codes
Medical Claim Billing with Patient Information
Electronic Claim Clearinghouse RelayHealth
Billing for Group Practices
CMS 1500 Medical Billing Claims
Medical Providers NPI Validation
Referring Providers NPI validation test
Claim Billing for Providers without a NPI
Medical Billing for CLIA waived Tests
Flu Shots
2008 deleted Procedure Codes for Medical Coding
Medical Coding updates of 2008 deleted Procedure Codes
Medical Billing and Coding Tips
Billing Medical Claims with Procedure Code 99354
Pediatrician Medical Billing
Aetna Health Care Insurance Medical Claims Billing
Aetna Health Care Insurance Dermabrasion Medical Billing
Think Green when Medical Billing and Coding
Medicaid Requires NPI
Health Alliance Medicaid and NPI updates
Electronic Claim Billing Oklahoma BCBS claim Exclusions
Maryland Medicaid and NPI updates for Medical Billing
Electronic Claim Billing Exclusions for missing NPI issues
Louisiana Medicaid NPI updates for Medical Billing
Missouri Medicaid NPI updates for Medical Billing
Electronic Certificate of Medical Necessity Forms for Medical Billing
Certified Medical Coding Trainer
Billing Medical Claims J0725 to Aetna Health Insurance
MediCal Modifier Update for Medical Billing Claims
Health and Human Services releases info on ICD-10
How to send a patient to outside collection agency
Billing 90669 and 90471 including screenshots of claim coding software
Aetna Health Insurance Medical Billing Claims Update on Attachments
Information on SCCIPA

Medicare Billing and Coding Course Information
Medicare Electronic Data Interchange Hotline
Proper Billing Steps when Medicare is the Secondary Insurance Carrier
How to resolve Overpayment issues with Medicare correctly
Waived CLIA Tests for Medicare
Resolve Podiatry Medical Billing Claim Issues
When Medicare can withhold the doctor’s insurance payment
Payment fees for Laboratory Travel Codes
2009 Medical Billing and Coding books available for purchase
Doctors can’t appeal Medicare Allowable Fee Schedules
Crossover Explanation of Benefits sent with incorrect rejections
Proper steps for emailing Medicare Health Insurance
How to Refund Medicare Health Insurance
Medicare Payments may look small
Electronic Claims Medicare Secondary Billing
Medical Billing and Coding using GA Modifiers
Medicare Secondary Payer MSP billing and coding situations
Electronic Claim Remittance Advice Remark Codes
Medicare Electronic Claims Crossover
MSP for Billing Medical CMS-1500 Claims
Medicare Remittance Advice Remark Codes Crosswalk
Submitting Electronic Claims as Secondary
Medicare Provider Bonus
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Physician Quality Reporting Initiative PQRI
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Medical Billing Insurance Phone Calls with Medicare - IVR
Understanding the PTAN number
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Top 10 Medical Billing Calls to Medicare
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Medicare Medical Claim exclusion H21084
Durable Medical Equipment Billing
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Q4097 Injection Code
Medicare ABN form updated
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Medical Billing for Active Duty in Armed Forces
National Drug Codes Claim Billing
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Supporting Documentation for Medical Billing Claims
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Medicare Holidays
Medicare NPI
Medicare Refund Forms Updated
Inpatient Hospital Medical Billing for Payment
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How to track what a Billing Service is doing through the Clearinghouse
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835 files deadline for BCBS of Florida
Wisconsin ForwardHealth update
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Iowa and South Dakota BCBS medical billing updates on NPI
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EDI error BO13 and how to fix
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New Mexico and Oklahoma Medicare Electronic Claim Submission updates
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Wellcare new Electronic Claim Exclusion edits for Medical Billing
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Florida Medicaid Updates for Electronic Medical Billing
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Dental Billing
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New Claim Edits for New York Preferred Care HMO

2008-12-05T18:27:00.000-08:00

New York Preferred Care HMO CPID# 7434 has new NPI requirements. Because of these changes RelayHealth will be implmenting a new electronic claim exclusion on December 5th 2008 for all claims submitted to CPID# 7434.

EDIT: HU 0021 INVALID CLAIM REF PROV ID QUAL? IN LOOP 2310A(PROF), WHEN NM108 IS SENT MUST BE EQUAL TO XX

Please understand that the NPI is now required when submitting claims through RelayHealth for New York Preferred Care HMO health insurance.

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

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Illinois Blue Cross Blue Shield Insurance Claims

2008-12-05T17:45:00.000-08:00

Blue Cross Blue Shield of Illinois has required medical offices to bill using a Rendering NPI number. If you use RelayHealth as your electronic insurance claim filing clearinghouse you will get specific denials relating to this issue.

BA7: NPI is not valid as rendering

If you receive this exclusion it means that "The NPI submitted on the claim to identify who provided the services is identified in our files as a billing entity, not a rendering provider." To rectify the above error message, the NPI of the provider who rendered the services should be populated in Loop 2310B - Data Element NM109, which is equivalent to Box 24J on the CMS-1500 claim form.

NOTE: You must continue to include the Billing NPI in Loop 2010AA - Data Element NM109. This Data Element is equivalent to Box 33A in the CMS-1500 Form.

If receiving Warning message: BAJ - Rendering Provider Loop (2310B) is Missing
Please be advised that this Warning message alerts you that "If the NPI billing provider record is NOT established as 'valid as rendering,' then the claim rendering provider loop (2310B) is required." In this situation, you must include the rendering provider's NPI in Loop 2310B - Data Element NM109. This Data Element is equivalent to Box 24J on the CMS-1500 claim form.

When filing claims, it is imperative, to include the rendering NPI (Type 1) in the rendering field (2310B Loop) and the billing NPI (Type 2) in the billing field (2010AA). The appropriate billing and rendering NPI must be entered properly to avoid claim rejection(s) and ensure proper payment.

Questions on Electronic Medical Billing and Claims then view medical claims electronic billing

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Electronic Claims EDI error BO13 Prov Phone 1

2008-12-01T08:13:00.000-08:00

For those medical offices billing through RelayHealth to insurance carriers CPID#1405 Illinois Blue Shield, CPID# 1406 Texas Blue Shield, CPID# 7403 New Mexico Blue Shield and/or CPID# 1403 Oklahoma Blue Shield you may have noticed a EDI Denial: B013 PROV PHONE 1 on November 14th 2008.

The invalid rejections have all been corrected and forwarded on to the correct payors. Please be aware of this fix.

Confused by Electronic Medical Claim Billing by clicking here electronic medical claim billing

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Seeing your Medical Office through the eyes of your patients

2008-11-29T16:06:00.000-08:00

After a few years of running a medical business doctors find themselves in a rut. I suggest taking a few minutes out on a slow day to look at your business from a new perspective. Take a pad of paper and pen and begin by starting from the parking lot.

Take in a few breathes, close your eyes and when you open your eyes look at things like a new patient might see them. Study your surroundings, scrutinize what you see and see how patients might feel when they see the same things.

Starting from the parking lot does your building have any curve appeal?
- repaint the building
- add flowers or trees
- add art
- new doors
- well lit outside if you work in the evenings

Walking into the building
- how does it smell
- does the place need new tile, paint, carpet cleaning

Restrooms
- Is it clean
- Is it functional

Opening Doors to your office
- What does it smell like
- What does it look like
- What does the front office desks look like
- Is their enough seating room

Front Office
- Do girls eat lunch at desks
- How do they answer the phones
- Is everyone well groomed
- Is everyone smiling to greet the patient
- Do they call the patient by their first name
- Are they pleasant when collecting the co-payment and outstanding balances

Walking down the hall to doctors office
- How are the carpets or tile
- Is everything dusty
- Is everything sanitized
- Are their scuffs on the walls (does it need to be repainted?)

Doctor Bedside Manners
- Is the doctor exercising and keeping fit
- Breathe check
- Clothing attire (over-dressed, under-dressed or just right?)
- Hand shake
- Eye Contact
- Understanding when to nod the head and when not to
- Listening skills

Doctors Office
- Office Equipment well maintained, no rips, no holes, no stains
- Chairs for patent's family
- Reading Materials
- Any smells

Taking this small 30 minute test every few years will help you identify if the building is looking drab, if the office is getting lazy in it's neatness and if their are areas that can be improved on. Fix the issues that you can now and make a list of things that you want to change over the next few months. I have learned that it's the simple things that can have the biggest impact on retaining patients for the next 50 years.

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

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Running a Successful Medical Practice

2008-11-29T14:39:00.000-08:00

Doctors go to College to learn how to be a doctor not on how to run a profitable Medical Practice Business. For every doctor you hear about that is making 6 figure salaries each month their are 50 other providers just trying to stay afloat.

Most doctors think they need to treat more patients a day to make more money but usually when you look at the aging reports you soon see it's not about treating more patients it's about collecting on the patients already treated.

Ask yourself these questions:

~Are you billing for ALL services you treated the patient for?
~Are charges getting entered and billed the same day as treatment?
~Are charts sitting around in different locations of your office waiting on forms to be completed?
~Is your billing department educated with your allowable fee schedules so they know they are collecting 100% of what is owed to you by procedure code? Are they going after the insurance carrier for claims that were underpaid?
~Are charges getting adjusted off just because the insurance carrier denies them?
~Does anyone work claims denied for timely filing, invalid procedure codes, invalid diagnosis codes, missing information, invalid modifiers, missing paperwork etc?
~Are patient balances getting adjusted off instead of being billed?
~Are medical liens being signed by attorneys and patients, workers compensation forms completed, Documentation attached to claims
~Are you sending claims electronically for all insurance carriers that you are credentialed with?
~Are you reading your EDI reports from the clearinghouse and working the denied claims?
~Are you re-billing claims that were denied or just fixing them and letting them sit in your A/R?
~Is someone checking claim status on everything that is 25+ days old?
~Are patients getting statements within the first month of treatment ensuring they will pay out almost 100% of the time?

Is it time for a change in the way you do business? Do you desire a profitable medical practice that actually helps patients? If you need help please leave a comment with your contact information and we will contact you or visit our www.medicalbillingsoftwarepro.com for PM vendor reviews, and www.videotrainingpro.com for online training videos. You can contact us through any of these websites for assistance on bettering your medical office flow to increase your monthly profits.

Practice Management Software Reviews

Medical Clearinghouse Reviews

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

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Medical Providers find Money in sending claims Electronically

2008-11-29T13:48:00.000-08:00

Back in the day (12+ years ago) medical claims were completed by hand or type writer. I remember putting the claim in upside down, and rolling it up so that I could add in the patients information, subscriber information and the CPT, Modifiers, ICD-9, and charge amount. It was so tedious. The doctor would treat between 8-14 patients a day and we would complete the forms and mail everything out on Friday.

About 30-45 days later (varied by insurance carrier) we would get an Explanation of Benefit back explaining if the claim was approved or denied. We used to keep a paper ledger of our patients to track any claims not paid (like I said this was 12 years ago and our doctor was old fashioned. We begged for a computer).

12 years ago it wasn't a priority to go electronic because not all insurance carriers were accepting claims electronically but now it's a NECESSITY and any doctor that is still processing paper claims is outdated and actually losing money. Let me show you what I mean:

Medical offices that are sending claims by paper have to wait until they are first received at the insurance carrier. So, if we billed claims every Friday and it took 2 days for the post office to deliver the claims + 1 day for the insurance carrier to scan the claims into their software we are now 3 days out. It takes the insurance carrier 15-25 days to process the claim and then another 3-5 days to process the check and mail everything back to the doctors office.

With good insurance carriers and if all things in the universe go right you will get your Explanation of Benefits with a check and a list of all patients that were denied along with those reason. Medical offices usually have collectors working on any past due or outstanding accounts that are 35+, 45+, 60+, 90+ and 120+ days old. Patients receive statements 35, 45, 65, 90 and sometimes over 180 days after treatment for co-payments, coinsurance and deductible balances. Mainly patients refuse to pay because they don't remember being treated, don't feel like they owe on such a old balance etc.

Doctors would have to adjust off patient balances and old insurance claims not including denials for untimely filing issues.

Now let's fast forward to the new era and how to collect your insurance carrier money faster -

1. The charges are entered the same day the patient is treated
2. Charges are scrubbed by medical coding software within minutes notifying the biller of any possible denial issues
3. If patient information is missing or incomplete the claim will not be transmitted to the insurance carrier alerting the biller of these issues
4. All claims get fixed the "same day" and billed to the clearinghouse
5. Clearinghouse scrubs the claims and send any back that do not meet the insurance carriers requirements per their contract with the insurance carrier
6. Within 24 hours those issues are fixed and the denied claims are rebilled
7. The insurance carrier sends a notification of status of claims within 72 hours indicating those that were approved vs. denied
8. Within 5 days of the patients treatment we have notification of the check # the claim will be processed towards
9. Within 10 business days from the date the insurance carrier receives the claim electronically we have an Electronic Remittance Advice along with the date the check will either be mailed to the provider or direct deposited into the providers checking account
10. Patients get a statement normally within 15-20 days of being treated and they pay almost 100% of the time because they actually remember the office visit, they remember what it was for and they realize they have a co-payment, coinsurance or deductible that is owed.

If you are a medical practice and not receiving insurance payments within 25 days of treatment for carriers like Aetna, UHC, Cigna, BCBS, Federal, Medicare, Medicaid, Medi-Cal, Humana or other insurance carriers that accept electronic claims then you need to look for a new billing service, a new Practice Management software or a new clearinghouse based on your results.
Practice Management Software Reviews
Medical Clearinghouse Reviews

1 step to increasing your monthly revenue is to take your billing electronically using a robust clearinghouse that processes eClaims, secondary claims electronically and Electronic Remittance Advice. For more information on how a clearinghouse can help your medical office please check out:

How to read EDI clearinghouse reports

Clearinghouse EDI Reports

Clearinghouse Online Claim Status EDI Reports

Confused by Electronic Medical Claim Billing click here for additional articles on this subject and so much more: electronic medical claim billing

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Move away from handwriting EDI Agreements

2008-11-29T13:39:00.001-08:00

More and more insurance carriers are getting away from handwriting and requiring EDI agreements for clearinghouses get completed electronically. Either type writing them (does anyone own a typewriter any more???) or by electronically completing the forms.

RelayHealth offers a online Collaboration Compass to complete EDI Agreements electronically. For medical offices that use clearinghouses it's wise to use the Clearinghouses software to complete all EDI agreements for electronic claims and electronic remittance advice to prevent any kick outs from insurance carriers.

The following list of insurance carriers are requiring electronic completion of forms and will no longer accept handwriting (except where the providers signature is required)

CPID 1455 Alaska Medicare
CPID 1456 Arizona Medicare
CPID 1459 Oregon Medicare
CPID 1462 Washington Medicare
CPID 1469 Iowa Medicaid
CPID 1523 North Dakota Medicare
CPID 1527 Utah Medicare
CPID 2411 North Dakota Blue Shield
CPID 2453 North Dakota Medicare
CPID 2454 South Dakota Medicare
CPID 2458 Utah Medicare
CPID 2466 Wyoming Medicare
CPID 2571 Iowa Medicaid
CPID 3521 Minnesota Medicare
CPID 3583 Wyoming Medicare
CPID 3584 Wyoming Blue Cross
CPID 5515 Oregon Medicare
CPID 5521 Washington/Alaska Medicare
CPID 5546 Arizona Medicare
CPID 5581 Idaho Medicare
CPID 5589 South Dakota Medicare
CPID 7400 Montana Medicare
CPID 7489 Wyoming Blue Shield

For more information on EDI's:
How to read EDI clearinghouse reports
Clearinghouse EDI Reports
Clearinghouse Online Claim Status EDI Reports
Practice Management Software Reviews
Medical Clearinghouse Reviews

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

Medical Billing Tags: Medical Billing, Medical Claims, Implementation of EDI Agreements, EDI forms, Electronic Data Interchange forms, completion of medical forms online to prevent denials, CMS-1500 electronic claim filing, Clearinghouses, Medical offices, providers, physicians, hospital facilities, billing services, Medicaid, Medicare, Blue Cross, Blue Shield, States, Insurance carriers, new rules for completing EDI agreements, Understanding clearinghouses, clearinghouse connections, how to bill insurance claims through a clearinghouse, education, training, teaching, skills, medical billing understanding, how to bill insurance claims electronically, how to be a medical biller from home, understanding simple processes, Electronic Remittance Advice, Electronic Explanation of Benefits, EOB's, physician billing, doctors, chiropractors, podiatry, surgery, pediatrician, speciality services, collections, web based medical billing, degree medical billing, electronic medical billing, electronic medical billing software, medical billing education, medical insurance billing software, medical billing and coding course, medical billing online course, medical billing software company, learn medical billing, insurance billing software, medical assistant school, medical billing course, medical billing program, medical billing and coding software, medical billing school, medical billing class, medical billing and coding online, medical billing certificate, medical billing systems, medical billing system, electronic medical claim billing, chiropractic practice management software, medical practice management system, medical practice management software, EMR practice management software, medical practice management services, practice management software, medical billing practice, Aetna Health, health insurance, Auto insurance, Auto Insurance Quotes, Auto insurance quote, Car Insurance Quotes, Commercial Insurance Quote, Car Insurance Quote, Car Insurance Quote, Employers Liability, Employers Liability insurance, Auto Insurance Companies, Property Insurance Quote, Car Insurance Companies, Auto Cheap Insurance, Accident Claim, Liability Insurance Quote, Employer Liability Insurance, Public Liability Insurance, lytec medical, lytec, web based medical billing software, medical billing software, medical billing systems

RelayHealth offers direct connection with Kaiser Mid Atlantic

2008-11-29T11:07:00.000-08:00

Starting November 19th 2008 RelayHealth is offering a direct connection to bill electornic claims and Remittance to Kaiser mid Atlantic for Professional (CMS-1500) and Institutional (UB-04) claims.

This is an exciting new direct connction for medical offices that use RelayHealth/McKesson as their clearinghouse.

The CPIDs included in this new connection are:
CPID 2819 Kaiser Mid Atlantic / Professional (CMS-1500)
CPID 7506 Kaiser Mid Atlantic /Institutional (UB-04)

You will not need to complete EDI Agreements (YEAH) for these direct connections either just enter the CPID# in the correct place for your PM vendor or Clearinghouse and transmit immediately.

The following payor reports will be available:
Unsolicited 277U
RelayHealth Standardized Payor reports for the above payors) will be available as soon as possible after November 20, 2008.

The following payor edits will be required by Kaiser Mid Atlantic:
Edit 01 version 0098 ? IN LOOP 2010BA, NM109 CAN NOT BE MORE THAN 10 CHARACTERS.
Edit HU version 0019 - IN LOOP 2010AA, NM108 MUST BE SENT AND MUST BE EQUAL TO 'XX'
Edit HU version 0020 - WHENI LOOP 2010AB IS SENT, NM108 MUST BE SENT AND MUST BE EQUAL TO 'XX'
Edit HU version 0022 - IN LOOP 2310B(PROF)/2310C(INST), NM108 MUST BE SENT AND MUST BE EQUAL TO 'XX'

If you have questions on EDI Reports please check out these earlier Blogs:
How to read EDI clearinghouse reports

Clearinghouse EDI Reports

Clearinghouse Online Claim Status EDI Reports

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

Medical Billing Tags: Kaiser, Kaiser Mid Atlantic, Professional Claims, Institutional Claims, CMS-1500 forms, HCFA forms, UB-04, UB92, Medical billing, billing insurance claims, claim filing, health insurance claim processing, new direct connection with McKesson Clearinghouse House through RelayHealth, 277 Reports, 277 EDI reports, how to read EDI reports, Claim edits, claim collections, claim submission, physician billing, health care provider billing, providers, medical office, billing service, understanding RelayHealth, how to process claims, how to post claims, how to bill claims, how to work insurance carriers, new direct connection with electronic claims processing, saving money in the medical industry, how to save money by billing claims electronically, medical coding and billing schools, medical billing schools online, medical coding and billing schools online, 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, medical billing software, medisoft medical billing software, web based medical billing, degree medical billing, electronic medical billing, electronic medical billing software, medical billing education

Oregon Medicaid transferring to a new MMIS system

2008-11-29T10:48:00.000-08:00

The replacement of Medicaid Management Information System (MMIS) is going live December 9th 2008. This new change will have an effect on how claims are submitted and how doctors are paid on medical claims. They have also added additional tools to speed things up and make it easier on all parties (medical offices, billing services, clearinghouses etc).

For clients that use RelayHealth as your clearinghouse to submit claims electronically to CPID#s 1481 & 5517 for Oregon Medicaid please be aware of these new updates:

RelayHealth is submitting the last electronic file to Oregon Medicaids current sysetm up to November 28th 2008
Claims will be held by RelayHealth if submitted between November 28th - December 8th 2008
On December 9th 2008 RelayHealth will send their first file to the NEW Oregon Medicaid MMIS claim processing system

Providers already approved with EDI Agreements thankfully do not need to re-register; however any new providers do require completed EDI Agreements in order to transmit claims electronically.

Providers that want to be setup with Electronic Remittance Advice (ERA) are required to complete a EDI Agreement for eRemittance. Anyone currently setup with ERA through RelayHealth will not be required to re-credential for this feature.

Please take a few minutes to register with MMIS training which is available online and can be found by visiting www.oregon.gov/DHS/mmis/training-info.shtml

A web-based provider eCourse is available through the DHS learning Center (select course C00818)

My recommendations is to watch claims closely for the first month. With anything this major in changing software be ready for Bugs. Be patient but also be ready to drop claims to paper if their are any issues with electronic claims files.

Another idea is to hold on to all claims from November 28th - December 15th and then submit. This will give both parties (RelayHealth and MMIS) to identify any bugs and fix them. This also means you won't have your claims involved with any mishaps.

If they do have problems with transmissions do not be afraid to press the Rebill button.

Happy Billing and Collecting!

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

Tag Words: Oregon, Ontario, Pendleton, Redmond, Eugene, beaverton, Roseburg, White City (medford), Coos Bay, Salem, Grants Pass, Tillamook, Hillsboro, Salem, Portland, Tualatin, MMIS, DHS, OHP clients, Web-based MMIS provider eCourse, Course information, Registration information, extended 2008 training schedule, professional, dental, institutional providers, pharmacy providers, POS/PBM training for pharmacies, physician claim billing, electronic claim billing, medical claim billing, medical office claim billing, billing service claim billing for Oregon Medicaid, eClaims, Electronic Claims submission, transmission stop and start dates, new claims filing features, functions, functionality, update to claims transmission for Medicaid of Oregon, Clearinghouse, RelayHealth, McKesson,

You can bill Texas First Health Plan through RelayHealth now

2008-11-29T10:43:00.000-08:00

All of my Texas clients need to be aware of the opportunity to bill electronic claims through RelayHealth to Texas First Health Plan starting immediately.

RelayHealth uses CPID# 4766 to transmit electronic claims to Texas First Health Plan. If you currently bill any medical claims to Texas First Health Plan by paper and use Clearinghouse RelayHealth please set up your Practice Management Vendor software or Clearinghouse Software to accept CPID#4766 and begin transmitting electronic claims immediately.

Questions on Electronic Claim Billing for Medical Health Insurance Carriers then click here for additional informationOnline Health Insurance Medical Billing

Tag Words: Medical claims, electronic billing, insurance billing, physician billing, health care insurance claims, Texas, Texas State insurance carriers, listing of Texas State Health insurance carriers, electronic claims filing, billing, claims processing, insurance claim filing, clearinghouse submission, setting up for electronic claims submission, submitting claims electronically through a clearinghouse, how to, free steps, free recommendations, Claim scrubbing, save money by sending claims electronically through Clearinghouse, medical office billing, billing services, Claim Submission software, practice management PM vendors, billing software requirements, medical coding and billing schools, medical billing schools online, medical coding and billing schools online, 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, medical billing software, medisoft medical billing software, web based medical billing, degree medical billing, electronic medical billing, electronic medical billing software,

New Jersey Medicare transitioning to Highmark Medicare Services November 14

2008-11-15T13:06:00.000-08:00

Payor agreements are required for electronic claims to CPID# 1465 New Jersey Medicare as they switch contractors.

Providers already approved to submit claims through RelayHealth are not required to complete an agreement.

New providers are required to complete an agreement.

Original Notification Sent on November 11, 2008: RelayHealth will be converting CPID 1465 New Jersey Medicare from National Government Services (NGS) to Highmark Medicare Services effective November 14, 2008.

Special requirements:
RelayHealth will be converting the existing Contractor ID 00805 to the new J12 Contractor ID 12402 on November 14, 2008.
Highmark Medicare Services will observes system dark days November 15, 2008 through November 17, 2008.

There will be no access to the MCS processing system, claim entry or claim corrections, and verify beneficiary eligibility and claim status as well as limited EDI processing.
Claims sent to Highmark Medicare Services between 4:00 PM on Friday November 15, 2008 and 4:00 PM on Monday November 17, 2008 will process on Monday night November 17, 2008. EDI report and ERA files will be available Tuesday November 18, 2008.
First payment cycle will take place on Monday night November 17, 2008. Checks and EFTs created will be dated November 18, 2008.
Customer Contact Center and IVR availability will not be available until Tuesday, November 18, 2008.

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

Payor agreements are not required for electronic claims.
Payor agreements are required for electronic remittance.

*Providers already approved to receive remittance through RelayHealth are not required to complete an agreement.
*New providers are required to complete an agreement.

The following payor reports will be available
*Batch Detail Control Listing
*Provider Summary Report & RelayHealth Standardized Payor reports for the above payor will be available as soon as possible after November 18, 2008

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

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New York Empire Medicare System Issue on October 6-9th 2008

2008-11-15T12:48:00.000-08:00

CPID 4442 New York Empire Medicare experienced a system issue from October 6, 2008 through October 9, 2008. RelayHealth has been working with the payor to receive the BATCH DETAIL CONTROL LISTING REPORT for files sent on October 7, 2008 and October 9, 2008. The payor attempted to reprocess the files which resulted in submitters receiving the HDIG CLAIMS CONFIRMATION REPORT with the following error message:

DUPLICATE FILE FOUND - FILE NOT PROCESSED.

RelayHealth is working with the payor to determine if all of the claims did process and to receive the complete reports. RelayHealth will send an update when the complete reports have been received.

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

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CPID# 3206 Healthcomp Inc will not be rerouted on Nov 19th 2008

2008-11-15T12:45:00.000-08:00

Update: CPID 3206 Healthcomp Inc. will not be rerouting on November 19, 2008.

Original Notification Sent on November 7, 2008:RelayHealth will change the electronic claims routing for the following payors as of November 19, 2008.

CPID(s) included in this routing change:
CPID 3276 AAG Benefit Plan Administrators, Inc. - Payor ID 75240
CPID 3869 American National Ins. Co. - Payor ID 74048
CPID 4269 Anchor Benefit Consulting - Payor ID 53085
CPID 3230 Automated Benefit Services - Payor ID 38259
CPID 2409 Benefit Source, Inc. - Payor ID 38257
CPID 1830 Brokerage Concepts - Payor ID 51037
CPID 3250 Butler Benefits - Payor ID 42150
CPID 3820 Community Health Alliance - Payor ID 35193
CPID 3268 Employer Plan Services - Payor ID 74212
CPID 3850 Formax, Inc. - Payor ID 87066
CPID 3206 Healthcomp Inc. - Payor ID 85729
CPID 8435 Kempton Group Administrators - Payor ID 73100
CPID 3271 MedCom - Payor ID 59231
CPID 3229 Midland Management/MFC - Payor ID 23550
CPID 5481 PPO Plus, LLC - Payor ID 72148
CPID 3467 Smith Administrator - Payor ID 02057
CPID 1758 UMWA Health - Payor ID 52180
CPID 2241 US Benefits - Payor ID 93092
CPID 3465 William C. Earhart - Payor ID 93050

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:
Initial Response Report
RelayHealth Standardized Payor Reports

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

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SCCIPA has a website for Online Claim Status

2008-11-15T12:21:00.000-08:00

For clients who use SCCIPA (Santa Clara County Individual Practice Assn) insurance in California they do offer a website service to check online claim status. Affinity Medical Group users can also log in to view claims for themselves also.

Please visit ppmsi.com and click on Access Express Login
Select if you want SCCIPA or Affinity
Click the Go button

If you are currently not registered click the Click Here to register for a Password or request more information.

The website is easy to use and very friendly to navigate through. In fact working claim status is a breeze and checking patient eligibility is a simplified process. No more phone calls necessary do all of your work from the website.

The website also offers a function allowing you to upload "batches" of PIF (Print Image Files) claims to their website. Within 24 hours they will indicate on the website if the whole batch was accepted or if a claim was denied for any reason. This is so much better than having to mail them paper (Costs) when you can do it Free through the PIF.

Happy Billing!

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

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November 14th you can begin billing Indiana University Medical Group Electronically

2008-11-15T12:15:00.000-08:00

If you use RelayHealth as your electronic claims processing Clearinghouse you will be happy to know that you can now begin billing claims to Indiana University Medical Group for both Professional and Institutional claims.

Starting on November 14th 2008 you can bill electronically once your EDI Agreements have been approved for processing. Indiana University Medical Group supplies the 277U and standardized Payor reports.

Please use CPID# 4481 to bill the Professional claims (CMS-1500) to Indiana University Medical Group (IUMG) and CPID# 4976 to bill Institutional Claims (UB-04) to Indiana University Medical Group (IUMG).

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

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Insurance Carrier EDI Reports Missing in November

2008-11-15T11:55:00.000-08:00

Between September 15 – November 11th not the insurance carrier’s entire front end rejects were wrote out to reports being returned to RelayHealth and then passed along to the customer. These rejects would include validation edits for syntax, structure, validation for correct format of dates, Federal Tax IDs, UPINs and correct qualifiers used. On November 14th RelayHealth received bulk reports which were forwarded on to their customer base.

Please be aware of the following insurance carriers that had these reporting issues and verify all claims are accounted for and online with the insurance carrier if not already processed and paid out:

They are listed by Payor Name, RelayHealth’s CPID#, phone number or contact information if any and the Payor ID # which is the 5 digit electronic number on the back of the insurance card.

AAG Benefit Plan Administrators,Inc.
3276
Refer to Member's ID card
75240
A and I Benefit Plan Administrators
3296
Refer to Member's ID card
93044
ABAS, Inc.
2842
(630) 416-1111
37225
ABC Health Plan of New York
3710
(631) 360-3102
48185
Abrazo Advantage Health Plan
2750
(602) 824-3747
E3510
Acclaim
5430
(601) 791-2970
64071
Acclaim Repricing
3813
Refer to Member's ID card
21356
ACS Benefit Services, Inc.
1843
(336) 759-2013
72467
Administrative Concepts, Inc.
3228
Refer to Member's ID card
22384
Advantra
7405
Refer to Member's ID card
25141
Advantra Freedom
3218
Refer to Member's ID card
25152
Advantra/Health America, Inc./Health Assurance
1797
Refer to Member's ID card
25126
Affinity Health Plan
2247
Refer to Member's ID card
13334
AFTRA Health Fund
3763
(212) 499-4800,
extension 274
13346
AGA
3878
Refer to Member's ID card
37280
AGIA, Inc.
3468
Refer to Member's ID card
95241
AHP - American Family
3289
Refer to Member's ID card
AHP01
Alaska Children's Services, Inc. (Group # P68)
1744
(206) 441-7574
91136
Alaska Electrical Health and Welfare Fund
2242
(907) 276-1246
92600
Alaska Laborers Construction Industry Trust (Group # F23)
1744
(206) 441-7574
91136
Alaska Pipe Trades Local 375 (Group # F24)
1744
(206) 441-7574
91136
Alaska United Food & Commercial Workers Health & Welfare Trust (Group # F45)
1744
(206) 441-7574
91136
All Savers Insurance Company
6483
(317) 290-8100
37602
Alliant Health Plans of Georgia
3793
(800) 811-4793
58234
ALICARE
5403
(212) 539-5556
13550
Allied Benefit Systems, Inc.
1759
(312) 906-8050,
extension 262
37308
Amalgamated Life
5403
(212) 539-5556
13550
AmeriBen Solutions, Inc.
3755
(800) 786-7930
75137
American Administrators Group
3276
Refer to Member's ID card
75240
American Benefit Administrative Services, Inc.
2842
(630) 416-1111
37225
American Chiropractic Network (ACN)
3784
(800) 236-9921
41161
American Chiropractic Network IPA of NY (ACNIPA)
3270
Refer to Member's ID card
41160
American Group
3862
Refer to Member's ID card
62030
American Healthcare Alliance
3895
Refer to Member's ID card
01066
American Imaging Management, Inc.
8433
(847) 559-6511
36369
American National Ins. Co. (ANICO)
3869
(806) 473-2433
74048
American Progressive
3233
Refer to Member's ID card
48055
American Republic Insurance Company
2895
(800) 640-9016
42011
American Worker Health Plan
3273
Refer to Member's ID card
37322
AmeriChoice of New Jersey (Medicaid NJ)
2806
(973) 297-5567 /
(602) 371-9235
86047
AmeriChoice of New Jersey Personal Care Plus (Medicare)
2853
(888) 362-3368
86001
AmeriChoice of New York (Medicaid NY)
2815
(212) 898-8328 /
(602) 371-9235
86048
AmeriChoice of New York Medicare Personal Care Plus (Medicare)
3748
Refer to Member's ID card
86002
AmeriChoice of Pennsylvania (Medicaid PA)
2827
(215) 523-6108 /
(602) 371-9235
86049
AmeriChoice of Pennsylvania Medicare, via Information Network Corporation (INC)
3839
(215) 832-4500
52192
AmeriChoice Pennsylvania Personal Care Plus (Medicare)
3749
Refer to Member's ID card
76003
AmeriHealth Administrators, Inc.
2893
(800) 841-5328
54763
AmeriHealth HMO - NJ and DE
2800
Refer to Member's ID card
23037
AmeriHealth Mercy Health Plan - Northern Pennsylvania
1710
(215) 937-8580
22248
Anchor Benefit Consulting
4269
Refer to Member's ID card
53085
Ancillary Benefit Systems
3811
(602) 417-2879
86062
Angeles IPA
2497
(437) 4284-1365,
extension 213
SYMED
Antares Management Solutions
2290
(440) 414-2247
34192
APA Partners
1883
(800) 833-3650
16140
Apex Benefit Services
3814
Refer to Member's ID card
34196
Arizona Physicians IPA
3432
(602) 664-5000
03432
Arkansas Best Corporation - Choice Benefits
2823
(501) 785-6178
75278
Arnett Health Plans
8457
(248) 372-3247
95440
ASR Physicians Care
4294
Refer to Member's ID card
38265
Assurant Health
6428
(414) 299-6317
39065
Asuris Northwest
4477
Refer to Member's ID card
SX179
Atlanticare Administrators
5470
Refer to Member's ID card
22304
Atlantis Health Plan
2856
(212) 747-8393
13853
Automated Benefit Services
3230
Refer to Member's ID card
38259
Automated Group Administration
3878
Refer to Member's ID card
37280
Avera Health Plans
1786
(605) 322-4500
46045
Bakersfield Family Medical Center
4241
Refer to Member's ID card
BKRFM
Banner Health Arizona
3845
Refer to Member's ID card
SX145
BCI Administrators, Inc.
2228
Refer to Member's ID card
49153
Bellflower Hospital
2497
(437) 4284-1365,
extension 213
SYMED
Benefit Administrative Systems, LLC
4287
Refer to Member's ID card
36149
Benefit Coordinators Corporation (Pittsburgh, PA)
3864
(800) 685-6100
25145
Benefit Management Systems North Carolina
3226
Refer to Member's ID card
56139
Benefit Plan Administrators Co. (Eau Claire, WI)
2882
(800) 236-7789 /
(715) 932-5535
http://www.bpaco.com
Claim Status
39081
Benefit Plan Administrators, Inc. (Roanoke, VA)
8482
(630) 428-5397
37118
Benefit Plan Management, Inc.
1889
(877) 642-7500
44273
Benefit Planners, Inc.
6472
(800) 292-5386,
extension 227
74223
Benefit Services Inc.
3291
Refer to Member's ID card
34178
Benefit Source, Inc.
2409
Refer to Member's ID card
38257
Benefit Systems and Services Inc.
8409
(708) 789-2082
36342
Berkshire Health Plan
1433
(610) 372-8044,
extension 3019
23243
Best Life & Health Insurance Co.
3269
Refer to Member's ID card
95604
Boilermakers National Health and Welfare Fund
6425
(913) 342-6555
36609
Boon-Chapman Administrators
1777
(512) 454-2681,
extension 140
74238
Bridgestone Claims Service
3893
Refer to Member's ID card
37285
Bridgeway Arizona
4288
Refer to Member's ID card
68054
Brokerage Concepts
1830
(630) 718-8128
51037
Brown and Towland Medical Group
1750
(415) 553-6512
94316
Butler Benefit
3250
Refer to Member's ID card
42150
C&O Employees' Hospital Association
2850
(518) 456-4566
23708
California Blue Cross - FEP only
1409
(800) 995-2800
94036
California Blue Shield
1409
(800) 995-2800
94036
Cannon Cochran Management Services, Inc.
3761
(800) 634-3506
37105
Cape Health Plan
5411
(313) 537-0220,
option 2
38245
Capitol Administrators
2810
(800) 331-5301
68011
Capital Blue Cross and Capital Advantage Insurance Company (CAIC)
2858
(800) 874-8433
23045
Capital Health Plan
4246
Refer to Member's ID card
95112
Care 1st Health Plan of Arizona
2289
Refer to Member's ID card
57116
CareCore National
3894
Refer to Member's ID card
14182
CareCore National, LLC - Health Net New Jersey
2268
Refer to Member's ID card
14185
CareCore National, LLC (Oxford Radiology Claims)
1727
(845) 298-8155,
extension 121
14180
CareCore National - Healthnet
3859
Refer to Member's ID card
14184
Carelink Advantra
1884
(304) 231-5015
25139
Carelink Health Plan
1884
(304) 231-5015
25139
Carelink Medicaid
3867
(800) 845-6592
25140
CareNet
2889
(302) 283-6570
25142
CareSource of Indiana
1439
(937) 531-3385
37311
CareWorks
3274
Refer to Member's ID card
10010
Cariten Healthcare
2870
(865) 374-4638
62073
Cariten Senior Health
2869
(865) 374-4638
62072
Carelink Medicaid
3867
(302) 283-6570
25140
Care Plus
2830
Refer to Member's ID card
65031
Carolina Care Plan, Inc.
2829
(800) 358-4471
57105
Carolina Crescent Health Plan
4470
Refer to Member's ID card
SX191
Carolina Summit Healthcare, Inc.
5466
(919) 875-2360,
extension 243
56195
Carpenters' Health and Welfare of St. Louis
3789
Refer to Member's ID card
25125
CBCA Administrators
3846
Refer to Member's ID card
55438
CBCA Administrators (HRM)
6459
Refer to Member's ID card
41170
CBSA
1708
(952) 593-6550
41124
CDS Group Health
4253
Refer to Member's ID card
88022
Cement Masons & Plasterers Health & Welfare Trust (Group # F16)
1744
(206) 441-7574
91136
Cenpatico Behavioral Health - Wisconsin

3220
(800) 225-2573,
extension 25525
68046
Cenpatico Indiana
3236
Refer to Member's ID card
68052
Centra Benefit Services
6480
(800) 344-5076
75196
Central Benefits Life
1845
Refer to Member's ID card
31118
Central Benefits Mutual
1845
Refer to Member's ID card
31118
Central Benefits National
1845
Refer to Member's ID card
31118
Central Reserve Life
6489
(800) 321-9997
34097
Central States Health and Welfare Funds
6492
(800) 325-5000
36215
CHA - Commonwealth Health Alliance
5477
Refer to Member's ID card
23171
CHAMPVA - HAC
3807
(800) 733-8387
84146
Chautauqua County Healthcare Plan - Mayville, NY
2231
Refer to Member's ID card
16600
Chesapeake Life Insurance Company
3713
(800) 733-8880
59223
Chesapeake Life Insurance Company - Student Insurance
6465
(800) 767-0700
74227
Children of Women of Vietnam Veterans - VA HAC
3807
(800) 733-8387
84146
Chinese Community Health Plan
3473
(415) 955-8800,
extension 3247
94302
CHOC - Childrens Hospital of Orange County Health
3265
Refer to Member's ID card
33065
Choicenet
3288
Refer to Member's ID card
CHCNT
CIGNA Healthcare for Seniors
5436
Refer to member's ID card
86033
City of Odessa (The)
3245
Refer to Member's ID card
75600
Claim Management Services (CMS)
2749
Refer to Member's ID card
39141
ClaimsWare, Inc. dba ManageMed
1725
Refer to Member's ID card
57080
Clear Choice Health Plan
3876
(877) 862-8644
77201
Colorado Access
2431
Refer to Member's ID card
84129
Columbia Cornell Care, LLC
1787
(212) 588-7342
25351
Commerce Benefits Group
3759
(800) 223-9941
34181
Commonwealth Administrator, LLC
3700
(859) 226-1559
37237
Commonwealth Care Alliance
3437
Refer to Member's ID card
14315
Community Care Behavioral Health Organization
5455
(412) 454-2129
25179
Community Care BHO
4248
Refer to Member's ID card
23282
Community Care Managed Health Care Plans of OK
1874
(918) 594-5295,
extension 4040
73143
Community Care Organization
2232
Refer to Member's ID card
39126
Community Family Care
2497
(437) 4284-1365,
extension 213
SYMED
Community Health Alliance
3820
Refer to Member's ID card
35193
Community Health Choice
3773
Refer to Member's ID card
48145
Community Health Electronic Claims /CHEC/webTPA
1706
(817) 633-9205
75261
Community Preferred Health Plan
5402
(715) 841-7399
39026
Community Premier Plus for Neighborhood Health Providers
3753
(631) 360-3102
32481
CompBenefits Corporation
2243
(800) 393-2873
37297
Comprehensive Behavioral Care
3462
Refer to Member's ID card
59314
Comprehensive Benefits Administrators, Inc.
3737
(800) 525-8788,
extension 8039
03036
Comprehensive Care Management Corporation
4250
Refer to Member's ID card
CCMC1
Consociate Group
3742
(800) 798-2422
37135
Consolidated Associates Railroad
2233
Refer to Member's ID card
75284
Continental General Insurance
3865
Refer to Member's ID card
71404
Cooperative Benefit Administrators (CBA)
6452
(402) 483-9200
52132
Cook Children's Health Plan
4751
Refer to Member's ID card
CCHP1
Cook Children's Star Plan
4752
Refer to Member's ID card
CCHP9
Coordinated Medical Specialists
1892
(877) 474-1713
58204
Core Administrative Services
3856
Refer to Member's ID card
58231
CoreSource AZ MN
6435
(612) 372-5466
41045
CoreSource Little Rock
3806
(972) 980-0900
75136
CoreSource of NC
1885
(704) 551-0500
35180
CoreSource Ohio
3254
Refer to Member's ID card
35183
CoreSource PA MD IL
3791
(717) 295-9201,
extension 343
35182
Corporate Benefit Services of America
1708
(952) 593-6550
41124
Corporate Benefits Services
3832
(800) 277-9476
56116
Corporate Systems Administration
3750
(423) 282-3420
37246
Correctional Medical Services, Inc.
2831
(314) 919-9817
43160
Cottage Health System
3791
Refer to Member's ID card
35182
Country Life Insurance Company
1711
(309) 821-3412
62553
Covenant Administrators, Inc. (Atlanta, GA)
3828
(800) 680-8728
58102
Coventry Diamond Plan
2474
Refer to Member's ID card
25131
Coventry Health and Life (Oklahoma)
1837
(800) 468-1442
25133
Coventry Health Care National Network
7490
(801) 954-4831
87043
Coventry Health Care of Delaware, Inc.
1813
(800) 833-7423
25130
Coventry Health Care of Georgia, Inc.
1733
(404) 526-6107
25127
Coventry Health Care of Iowa, Inc.
1836
(800) 470-6352
25132
Coventry Health Care of Kansas, Inc. - Kansas City
1837
(800) 468-1442
25133
Coventry Health Care of Louisiana, Inc.
1839
(800) 245-8327
25135
Coventry Health Care of Nebraska, Inc.
1840
(800) 471-0240
25136
Coventry Health Care of the Carolinas, Inc. / Wellpath
1762
(800) 845-6592
25129
Creative Medical Systems
5474
Refer to Member's ID card
64068
Croy-Hall Management Inc.
3244
Refer to Member's ID card
37266
CWIBENEFITS, Inc.
1725
Refer to Member's ID card
57080
Definity Services
3797
(716) 319-5129
64159
Denver Health and Hospital Authority
2433
Refer to Member's ID card
84133
Department of Labor
4754
Refer to Member's ID card
77044
Dermatology Network Solutions, Health Options
2434
Refer to Member's ID card
DNS22
Dermatology Network Solutions, LLC Blue Cross Blue Shield
2797
Refer to Member's ID card
DNS22
Dermatology Network Solutions, LLC Humana
2796
Refer to Member's ID card
DNS77
Destiny Health
3882
Refer to Member's ID card
36436
Detroit Medical Center
2406
Refer to Member's ID card
56240
Doctors Hospital of Montclair (San Bernadino
2497
(437) 4284-1365,
extension 213
SYMED
Directors Guild of America
3881
(323) 866-2200
23706
Diversified Administration
6481
(888) 498-6664
06102
Driscoll Childrens Health Plan
3234
Refer to Member's ID card
74284
Dunn & Associates
2293
(812) 378-9960
35186
E3 Health
1857
(972) 687-1805
75232
East Bay Medical Network
1809
(510) 627-4763
94318
Eau Claire Health Protection Plan
5402
(715) 841-7399
39026
Eau Claire Providers Choice
5402
(715) 841-7399
39026
Elder Health HMO of Pennsylvania
3839
Refer to Member's ID card
52192
Elder Health Maryland HMO, Inc.
3839
Refer to Member's ID card
52192
ElderPlan, Inc.
1853
Refer to Member's ID card
31625
Elmco
1498
Refer to Member's ID card
37253
El Paso First Chip
4289
Refer to Member's ID card
TH090
Employee Benefit Concepts (Farmington Hills, MI)
3705
(248) 855-8040
38241
Employee Benefit Management Corporation (EBMC)
3207
(877) 304-0761
31074
Employee Benefit Management Services (EBMS)
5483
Refer to Member's ID card
SX182
Employee Benefit Plan Administrations, Inc. (E.B.P.A.)
3737
(800) 525-8788,
extension 8039
03036
Employee Benefit Services
2836
(630) 718-8230
37216
Employee Plans, LLC
1834
(219) 436-1616,
option 2
35112
Employer Plan Services
3268
Refer to Member's ID card
74212
Employers Coalition on Health
4277
Refer to Member's ID card
27008
Employers Direct Health - FI
3241
Refer to Member's ID card
75235
Employers Direct Health - SF
2218
Refer to Member's ID card
75233
Employers Insurance of Wausau
5402
(715) 841-7399
39026
Employers Life Insurance Corporation
3884
Refer to Member's ID card
37249
Employers Mutual, Inc. (FL)
1716
(800) 697-2235
59298
Encircle PPO
2825
(888) 446-5844
35206
Encompass
1789
(630) 718-8128
37110
Encore Health Network
2825
(888) 446-5844
35206
ENH Medical Group IPA
8481
(866) 295-1403
36364
Enstar Natural Gas (Group # P61)
1744
(206) 441-7574
91136
Equitable Plan Services
3217
Refer to Member's ID card
73126
Erin Group Administrators, Inc.
5469
(717) 581-1300,
extension 224
23250
E-V Benefits Management, Inc. (Columbus, OH)
8430
(800) 321-4085
34159
Evergreen Health Plan
5418
(706) 660-6148
58233
F.A. Richard & Associates, Inc.
2211
Refer to Member's ID card
37289
FACS Group
3854
Refer to Member's ID card
37300
Family Health Partners MC + Missouri
3709
(816) 855-1843
43173
Family Medical Network
2479
(773) 572-8309
36396
FamilyCare (Medicaid HMO)
4759
Refer to Member's ID card
FCD01
FamilyCare (Medicare Advantage Plan)
4758
Refer to Member's ID card
FCR01
FARA
2211
Refer to Member's ID card
37289
FARA Benefit Services, Inc.
2211
Refer to Member's ID card
37289
FCE Benefit Administrators
3253
Refer to Member's ID card
33033
Federate Mutual Insurance
1873
Refer to Member's ID card
41041
Fidelis Secure Care
4748
Refer to Member's ID card
77054
First Carolina Care
1804
(910) 215-5268
56196
First Choice of Midwest - PPO
2256
Refer to Member's ID card
75138
First Health Network
2875
(405) 843-9551
73159
FiServe Health (Kansas and Tennessee)
1806
(615) 360-4660
62061
Florida Hospital Healthcare Systems
5414
(407) 741-4875
59321
Florida Hospital Waterman
5472
(913) 685-4740
48116
FMH Benefit Services, Inc.
5492
(913) 685-4740
48117
Formax, Inc.
3850
Refer to Member's ID card
87066
Fortis Benefits Insurance Company
1760
(800) 800-8463 or
(414) 271-3011
70408
Fortis Insurance Company
6428
(414) 299-6317
39065
Fox Everett, Inc.
5433
(601) 364-5291
64069
Fresenius
4745
Refer to Member's ID card
4745
Fringe Benefit Management
1862
(630) 428-5397
59069
Garfield Medical Center
2497
(437) 4284-1365,
extension 213
SYMED
Geisinger Health Plan
5473
(800) 447-4000
75273
Genworth Life and Health Insurance Company (GLHIC)
6419
(800) 451-2513
67815
GHI HMO - NY
1784
(914) 340-2338
25531
GI Innovative Management
1892
(877) 474-1713
58204
GIC Indemnity Plan
8473
(800) 543-4556,
extension 5661
80314
Gilsbar, Inc.
2802
(504) 898-1673
07205
Glassworkers Health & Welfare Fund (Group # F29)
1744
(206) 441-7574
91136
Golden Rule Insurance
6483
(317) 290-8100
37602
Government Employees Hospital Association (GEHA)
6467
(800) 821-6136
44054
Great Lakes Health Plan
1886
(248) 331-4348
95467
Greater La Crosse Care 65+
5402
(715) 841-7399
39026
Greater Wisconsin Rapids Provider Choice
5402
(715) 841-7399
39026
Green Bay Health Protection Plan
5402
(715) 841-7399
39026
Group Administrators LTD.
1770
(847) 519-1880,
extension 225
36338
Group Health Cooperative of South Central WI
1876
(262) 787-2705
39167
Group Health Plan (GHP) / Advantra
7405
Refer to Member's ID card
25141
Guardian Life Ins. Co. of America
6409
(414) 749-9200
64246
Gundersen Lutheran Health Plan
3833
Refer to Member's ID card
39180
Harrington Benefit Services, Inc.
6431
(800) 551-2022
95266
Harrington Benefit Services, Inc. (Oklahoma)
1751
(614) 470-7383 /
(614) 470-7427
59142
HCH Administration
1790
(630) 718-8128
37111
HCHA Albq-Self Funded
3261
Refer to Member's ID card
37329
HDPC Alliance Physicians
3471
Refer to Member's ID card
20257
Health America Inc./Health Assurance/Advantra
1797
Refer to Member's ID card
25126
Health Assurance/Health America Inc./Advantra
1797
Refer to Member's ID card
25126
Health Claim Services
3267
Refer to Member's ID card
82018
Health Cost Solutions
3805
(615) 590-1224
62111
Health First (Tyler, Texas)
1768
(972) 980-0900,
extension 218
75234
Health Future LLC
4475
Refer to Member's ID card
30946
Health Market Care Assured
4467
Refer to Member's ID card
62295
Health Net of the Northeast
4483
Refer to Member's ID card
06108
Health Net Pearl
4235
Refer to Member's ID card
SX185
Health Network America
1454
(732) 676-2637,
extension 123
20199
Health Partners - Jackson, TN
5458
(800) 825-8929
62157
Health Partners, PA
2822
(215) 991-4350
80142
Health Plan of San Joaquin
3469
Refer to Member's ID card
68035
Health Plans Inc.
1889
(800) 343-7674,
extension 140
44273
Health Plus PHSP - Brooklyn, NY
1898
Refer to Member's ID card
11324
Healthcare Group (The)
2825
(888) 446-5844
35206
Healthcare Management Administrators
1717
Refer to Member's ID card
TH049
Healthcare USA
3840
Refer to Member's ID card
25143
HealthChoice of Arizona
3232
(480) 731-3514
62179
Healthcomp Inc.
3206
(559) 499-2450,
extension 2378
85729
Healthfirst, Inc. – New York
1854
(212) 801-6078
80141
HealthGuard of Lancaster
8439
(717) 581-4569
23226
Healthhelp Networks, Inc. (HHNI)
6476
(904) 239-5709
59087
HealthLink HMO
1817
(314) 872-9643
96475
HealthLink PPO
4448
(800) 624-2680
90001
HealthPledge HMO/Plus
5435
(614) 566-0213
95435
Health Plus of Louisiana
2258
Refer to Member's ID card
95009
HealthSCOPE Benefits, Inc.
8413
(501) 225-1551
71063
HealthSource/Hudson Health Plan
6451
(914) 372-2291
13335
Healthstar, Inc.
8400
(773) 693-7827
36332
Healthways WholeHealth Networks
4740
Refer to Member's ID card
58213
H.E.R.E.I.U. Welfare Pension Plan Funds
2865
(630) 236-5262 /
(630) 428-5397 /
(630) 369-5300
(Customer Support)
37114
Heritage Consultants
2874
(863) 967-4139
59230
Heritage New York Medical Group
1723
(516) 746-2200,
extension 222
11328
High Desert Primary Care
3470
Refer to Member's ID card
33069
Hill Physicians Medical Group
2846
(800) 445-5747
00046
HIP – Health Insurance Plan of Greater New York (CareCore)
1896
(212) 630-8711
55247
HMA
4753
Refer to Member's ID card
86066
Hollywood Presbyterian
2497
(437) 4284-1365,
extension 213
SYMED
Hometown Health Plan
2839
(775) 982-3233
88023
Horizon Blue Shield of New Jersey
2414
(973) 466-7333
22099
Horizon NJ Health
1709
(215) 937-8580
22326
Hotel Employees & Restaurant Employees Health Trust (Group # F19)
1744
(206) 441-7574
91136
HPS Paradigm, Inc.
3778
(229) -387-2857
58227
Hunt Insurance Group
3478
Refer to Member's ID card
37260
I E Shaffer
3240
Refer to Member's ID card
22175
IBI
1708
(952) 593-6550
41124
ICARE, Independent Care Health
2285
Refer to Member's ID card
11695
IMCARE
3764
(800) 657-3613
41600
INDECS Corporation
3896
(201) 460-3225
40585
Independence Medical Group
4242
Refer to Member's ID card
MHM01
Indiana Health Network
2860
(317) 284-7787
35204
Indiana ProHealth Network
1754
(317) 588-7565
35161
Indiana Teamsters Health Benefits Fund (Indianapolis, IN)
2826
(440) 720-0700,
extension 222
35107
InforMed, LLC
3727
(800) 459-2110
52196
Inland Empire Health Plan
4244
Refer to Member's ID card
IEHP1
Innovative Healthware Services
2814
(877) 609-2467
04320
Insurance Administrators of America, Inc.
3237
Refer to Member's ID card
37279
Insurance Design Administrators
2871
(201) 337-0007,
extension 207
13315
Insurers Administrative Corporation
2484
Refer to Member's ID card
86304
Integra Group
1864
Refer to Member's ID card
31127
Integra Group - CHA
3860
Refer to Member's ID card
31129
Integrity Benefit Group, Inc. (The)
3712
(770) 428-1604
58200
InterCare Health Plans, Inc.
3720
(303) 770-5710
37227
InterGroup Services Corp.
5485
(800) 537-9389,
extension 103
23287
International Union of Operating Engineers Local 15
3260
Refer to Member's ID card
37269
Interwest Health - Acceptius Gateway Payor
3451
Refer to Member's ID card
84137
Iowa Benefits, Inc.
1708
(952) 593-6550
41124
Jackson Memorial Health Plan
2777
(305) 575-3680
05014
Jackson Memorial Health Plan - Medicaid
2784
(305) 575-3680
09822
John Muir Mt. Diablo Health System
2284
Refer to Member's ID card
68036
John P. Pearl & Associates
3717
(630) 718-8230
37215
JP Farley Corporation
3771
(800) 634-0173
34136
Kaiser Foundation Health Plan of Southern CA Region
1703
(213) 259-4377
94134
Kaiser Foundation - Mid-Atlantic States
2819
(301) 625-6665
52095
Kaiser Permanente Insurance Company
4293
Refer to Member's ID card
94320
Kanawha HealthCare Solutions, Inc.
2837
(800) 822-1274
57038
Kanawha Insurance Company
2837
(800) 822-1274
57038
Kempton Company
8435
(405) 521-1711
73100
Kempton Group Administrators
8435
(405) 521-1711
73100
Kern Health Systems
3803
(800) 391-2000
77039
Key Benefit Administrators, Inc.
2821
(630) 718-8230
37217
Key Health Plan
5402
(715) 841-7399
39026
Keystone Mercy Health Plan
8475
(215) 937-8580
23284
La Crosse Care Plan
5402
(715) 841-7399
39026
Lakeside Health Services
8414
(800) 637-2000,
extension 1120
95415
Landmark Insurance
3294
Refer to Member's ID card
LNDMK
Leon Medical Center Health Plan
2282
Refer to Member's ID card
37316
Life Trac
3844
Refer to Member's ID card
41136
LifeWise Healthplan of Arizona
3212
Refer to Member's ID card
91155
LifeWise Healthplan of Oregon
2854
(800) 435-2715
93093
Local 135 Health Benefits Fund (Indianapolis, IN)
2826
(440) 720-0700,
extension 222
35107
Lovelace Salud
2251
(614) 212-7383
SX159
Lumenos
3837
Refer to Member's ID card
54195
MacNeal Health Providers- CHS
2270
Refer to Member's ID card
36334
Mail Handlers Benefit Plan
6402
Refer to Member's ID card
62413
Magellan Health Services (Magellan Behavioral Health)
1419
(800) 297-7821,
extension 3799
01260
Magnacare
1704
Refer to Member's ID card
11303
Makskin Management
4462
Refer to Member's ID card
22195
Managed Care America
4421
Refer to Member's ID card
25168
Managed Care Services
1878
(219) 496-4100,
extension 64139 or
(219) 496-4137
35162
Managed Care Systems (Delango Regional Medical)
4238
Refer to Member's ID card
MCS02
Managed Health Network
1495
(615) 231-7901
22771
Manatee Service Center (Bradenton, FL)
3728
(941) 742-5700
41555
Mashantucket Pequot Tribal Nation
2818
(630) 718-8230
37121
Massachusetts Blue Shield
2424
(800) 419-4419
SB700
Mayo Management Services, Inc. (MMSI)
2752
(800) 635-6671
41154
McCreary Corporation (EMI)
2844
(561) 287-7650
59331
McLaren Health Pan
3794
(888) 327-0671
38338
MDNY Healthcare
1781
(800) 707-6369
11338
MDWise Hoosier Alliance Health Plan
3214
(317) 697-7987
20475
MedAdmin Solutions (formerly Advanced Data Solutions, Inc.)
1707
(770) 850-7480
58202
MedAdmin Solutions
1892
(877) 474-1713
58204
MedCom
3271
Refer to Member's ID card
59231
MedCost Benefit Services (MBS)
1880
(336) 774-4419
56205
MedCost, Inc.
6474
(800) 433-9178,
extension 257
56162
Medfocus
3765
(800) 398-8999,
extension 150
95321
Medica
1431
(800) 458-5512
94265
Medica Health Care Plan, Inc.
4243
Refer to Member's ID card
78857
Medical Benefits Administrators (Newark, OH)
1728
(800) 423-3151
74323
Medical Benefits Companies (Newark, OH)
1728
(800) 423-3151
74323
Medical Benefits Mutual (Newark, OH)
1728
(800) 423-3151
74323
Medical Benefits Mutual Life Insurance Company
1728
(800) 423-3151
74323
Medical Claims Service, Inc.
2811
(304) 273-5384
04258
Medical Development International
2252
(904)-473-1200
52181
Medical Mutual of Ohio
4423
(800) 362-1279
29076
Medical Resource Network
3744
(972) 447-6464
58203
Mediversal
1427
(702) 248-2542
37304
MedSolutions Inc.
1825
(800) 467-6424,
extension 1714
(Customer Service) or
(800) 467-6424,
extension 1552
(Technical Assistance)
62160
MEGA Life and Health Insurance Company - OKC
3209
Refer to Member's ID card
59227
MEGA Life and Health Insurance Company - Student Insurance
6465
(800) 767-0700
74227
MEGA Life and Health Insurance Company (The)
2894
(800) 527-2845 -
numeric Insured ID,
(800) 733-8880 - alphanumeric Insured ID
59221
MEGA Life and Health Insurance Company (The) - Starbridge StarHRG
3885
Refer to Member's ID card
59225
Memphis Managed Care
1879
(901) 725-7100,
extensions 3013, 3114, 3956
36193
Mesa Mental Health
3252
Refer to Member's ID card
85035
Metro Plus Health Plan
2296
Refer to Member's ID card
13265
Michael Reese Physicians Group
2804
(630) 428-5397
37127
Mid-Atlantic Medical Services, Inc. (MAMSI)
5406
(800) 342-6141
52148
Mid-County Physicians Medical Group (San Diego)
2497
(437) 4284-1365,
extension 213
SYMED
Midland Management / MFC
3229
Refer to Member's ID card
23550
Mid-West National Life Insurance Co. of Tennessee - Student Insurance
6465
(800) 767-0700
74227
Mid-West National Life Insurance Company of Tennessee
3714
(800) 733-8880
59224
MidSouth Administrative Group
5451
(901) 821-6723
62168
Midwest Security Administrators
7482
(800) 542-6642,
extension 797
79480
Mississippi Select Health Care
3785
(800) 847-6621
64088
Missoula County Medical Benefits Plan
3446
Refer to Member's ID card
37275
Missouri Care
1479
(800) 322-6027
43179
Mississippi Public Entity Employee Benefit Trust
3871
Refer to Member's ID card
37233
MMS, LLC
3853
Refer to Member's ID card
62178
Molina Healthcare of Utah
4237
Refer to Member's ID card
SX109
Monarch IPA
2475
Refer to Member's ID card
IP095
Montefiore CMO
2817
(718) 405-4329
13174
Motorola Inc.
8429
Refer to Member's ID card
36111
Mountain States Administrative Services (Tucson, AZ)
3810
(520) 722-0811
86040
MPE Services Inc.
3871
Refer to Member's ID card
37233
MPEEBT
3871
Refer to Member's ID card
37233
MPLAN, Inc./HealthCare Group, LLC
5479
(317) 571-6538
95444
Multicultural Primary Care Medical Group (San Diego)
2497
(437) 4284-1365,
extension 213
SYMED
Mutual Assurance Administrators
3875
Refer to Member's ID card
37256
NAA (North American Administrators, L.P.) (Nashville, TN)
3812
(800) 411-3650 /
(615) 256-3561
65085
NABN (Cleveland, OH)
8430
(800) 321-4085
34159
National Benefit Administrators - New Jersey
3768
(440) 720-0700,
extension 215
56175
National Benefit Administrators - North Carolina
3769
(440) 720-0700,
extension 222
56176
National Health Insurance Company
3868
Refer to Member's ID card
75275
National Imaging Associates
4485
Refer to Member's ID card
NIA11
National Rural Electric Coop (NRECA)
6452
(402) 483-9200
52132
National Telecommunications Cooperative Association (NCTA)
2407
Refer to Member's ID card
52103
Nationwide Health Plans
6487
(800) 626-2904
31417
NCAS - Charlotte
3874
Refer to Member's ID card
75191
NCAS - Fairfax, VA
1730
(703) 934-6297
75190
Neighborhood Health Partnership of Florida
2721
Refer to Member's ID card
96107
Neighborhood Health Plan of Rhode Island
2487
Refer to Member's ID card
05047
Nesika Health Group
3251
Refer to Member's ID card
37255
Network Health
5475
(617) 806-8121
04332
Network Health Plan of Wisconsin
1783
(920) 720-1413
39144
Nevedacare
4275
Refer to Member's ID card
869066
New Era Life Insurance Company
1477
(800) 608-8366
75281
New Jersey Carpenters Health Fund
2214
(732) 417-3900,
extension 358
22603
New Market Dimensions
3892
(800) 570-6745
65056
New West Health Plan
1812
Refer to Member's ID card
84141
New York Group Health Inc. - Commercial
2744
(212) 615-0234
13551
New York Presbyterian Community Health Plan
3711
(631) 360-3102
48186
NHP/SHP - Neighborhood Health Providers/Suffolk Health Plan
1811
(631) 360-4955,
extension 302
11325
North American Benefits Network (Cleveland, OH)
8430
(800) 321-4085
34159
North Broward Hospital District
2269
Refer to Member's ID card
37314
North Texas Healthcare Network
1746
Refer to Member's ID card
35212
Northern California Sheet Metal Workers Health Care Plan
2219
Refer to Member's ID card
38238
Northern Illinois Health Plan
2291
(815) 599-7050
36347
Northern Nevada Trust Fund
3721
(800) 423-1841,
extension 203
88027
Northridge Medical Group
3227
Refer to Member's ID card
NMG01
Northwest Suburban IPA (Illinois)
3736
(888) 747-2264 /
(815) 490-6798
36346
Nova Healthcare Administrators, Inc. (Grand Island, NY)
5486
(800) 999-5703
16644
NovaSys Health Network
3733
(501) 219-4444
71080
N.W. Ironworkers Health & Security Trust Fund (Group # F15)
1744
(206) 441-7574
91136
N.W. Roofers & Employees Health & Security Trust Fund (Group # F26)
1744
(206) 441-7574
91136
N.W. Textile Processors (Group # F14)
1744
(206) 441-7574
91136
Nyhart
3842
Refer to Member's ID card
37299
NYMI / Aetna (CareCore)
2835
Refer to Member's ID card
14179
OATH (The) - A Health Plan of Alabama, Inc.
2851
(800) 743-7141
63092
Ohio Health Choice, PPO
1860
(800) 544-0027
34189
Ohio Health Group
5435
(614) 566-0213
95435
Omnicare, A Coventry Health Plan
3872
(866) 440-3818
25150
One Call Medical
4254
Refer to Member's ID card
22321
OneNet PPO, LLC
3777
(800) 324-6141
52149
Operating Engineers Locals 302 & 612 Health & Security Fund (Group # F12)
1744
(206) 441-7574
91136
Orthonet Corporation - CIGNA
2264
(866) 874-0727
13381
Optimum Choice of the Carolinas, Inc. (OCCI)
3277
Refer to Member's ID card
52152
OSF Health Plan
2723
Refer to Member's ID card
62171
Oshkosh Area Health Protection Plan
5402
(715) 841-7399
39026
Orthonet - Aetna
2263
Refer to Member's ID card
13383
Orthonet - HealthNet
3208
Refer to Member's ID card
25681
P5 Health Plan Solutions of Utah
2217
Refer to Member's ID card
87068
Pacific Alliance Medical Group and Hospital
2497
(437) 4284-1365,
extension 213
SYMED
PacifiCare Behavioral Health
2867
(800) 716-1166
33053
PacifiCare Claims (CA, OK, OR, TX, WA)
2816
(800) 624-8822,
(Customer Service)
(714) 226-2442,
(General EDI)
(714) 226-5139,
(Technical EDI)
95959
PacifiCare Health Systems - PPO
3808
(800) 778-8887
95999
PacifiCare of Arizona
3439
(602) 350-9500
95964
PacifiCare of California (Encounters only)
2740
(714) 236-5841
95958
PacifiCare of Colorado
2428
Refer to Member's ID card
95962
PacifiCare of Oklahoma (Encounters only)
2740
(714) 236-5841
95958
PacifiCare of Oregon (Encounters only)
2741
(503) 617-3550
95958
PacifiCare of Texas (Encounters only)
2740
(714) 236-5841
95958
PacifiCare of Washington – Encounters
5468
(206) 230-7313
95958
PAI
3883
Refer to Member's ID card
37287
Paragon Benefits, Inc.
3453
Refer to Member's ID card
58174
Parity Healthcare LLC
1892
(877) 474-1713
58204
Parkland Community Health Plan
1763
(888) 672-2277 or
(214) 932-4549
66917
Passport Advantage
2446
Refer to Member's ID card
SX154
Passport Health Plan (Kentucky Medicaid Region 3)
6473
(215) 937-8580
61129
Patient Advocates
3247
Refer to Member's ID card
10525
Pennsylvania Preferred Health Network - PPHN
4746
Refer to Member's ID card
06161
People's Health Network
8455
(504) 461-4145
72126
Perfect Health
4236
Refer to Member's ID card
13522
Performax, Inc.
1708
(952) 593-6550
41124
Personal Care
3796
(314) 506-1917
25146
Phoenix Health Plans
3440
(602) 824-3720
03440
PHP Tenncare
1893
(865) 470-7563
(865) 374-4638
62155
Physicians Alliance Corporation (The) / SRRIPA
3235
Refer to Member's ID card
15749
Physician Associates of Louisiana
1892
(877) 474-1713
58204
Physician Health Association of Illinois
3770
(800) 598-3986 /
(815) 490-6797
37136
Physicians Care Network (Rockford, IL only)
2840
(815) 963-6699 /
(800) 642-2948
36345
Physicians Health Plan of Northern Indiana
3815
(800) 982-6257,
extension 549 /
(260) 969-2428
12399
Physicians Plus Insurance Corporation
5478
(972) 577-7404
39156
Piedmont Administrators
1880
(630) 718-8230
56205
Pinnacol
2798
Refer to Member's ID card
CCIA1
Pittman & Associates
3743
(630) 718-8230
37224
Planned Administrators, Inc.
3883
Refer to Member's ID card
37287
Podi Care Managed Care
1892
(877) 474-1713
58204
Podiatry First
4251
Refer to Member's ID card
PDFST
Poly America Medical & Dental Benefits Plan
2220
Refer to Member's ID card
32680
POMCO
1779
Refer to member's ID card
16111
PPOPlus LLC
5481
(806) 473-2433
72148
Practicare
1888
(770) 795-3488
04334
Prairie States Enterprises
3891
Refer to Member's ID card
36373
Preferred Benefits Administrator
2432
Refer to Member's ID card
61665
Preferred Care Partners
2240
Refer to Member's ID card
65088
Preferred Community Choice/PCCSelect/CompMed
1791
(800) 884-4776 or
(918) 594-5212
73145
Preferred Health Plan, Inc.
1807
(502) 339-7500,
extension 213
61106
Preferred Healthcare System - PPO Altoona, PA (The)
2814
(877) 609-2467
04320
Preferred Healthcare Systems Insurance Company - Kansas
3767
(800) 238-9900
60110
Preferred IPA
3225
Refer to Member's ID card
PFIPA
Preferred Network Access, Inc.
3831
(630) 493-0905
36401
Preferred Plus of Kansas
3767
(877) 609-2467
60110
Premier Health Systems, Inc.
2292
Refer to Member's ID card
90440
Presbyterian - New Mexico
2255
(505) 923-8726
05003
Presbyterian Salud
4252
Refer to Member's ID card
PRESA
Prime Vision Health
1795
Refer to Member's ID card
56190
PrimeSource Health Network PPO - Harrisburg, PA
2814
(877) 609-2467
04320
Professional Benefit Administrators, Inc. (Oak Brook, IL)
2807
(630) 655-3755,
option 1
36331
Professional Claim Administrators (ProClaim)
3708
(952) 546-0310
41163
Professional Claims Management (PCM)
2899
(330) 493-7278
37242
Puget Sound Benefits Trust (Group # F25)
1744
(206) 441-7574
91136
Puget Sound Electrical Workers Trust (Group # F33)
1744
(206) 441-7574
91136
Puget Sound Health Partners
4762
Refer to Member's ID card
42712
Pyramid Life
3233
(800) 444-0321
48055
QualCare, Inc.
1713
(800) 992-6613,
extension 5
23342
QualChoice of Arkansas
5428
(501) 228-7111,
extensions 5113 and 5052
35174
Quincy Health Care Management, Inc.
8410
(217) 222-9157,
extension 5151
37129
QVI Risk Solutions
1769
Refer to Member's ID card
57117
RBMS, LLC
3863
(806) 473-2433
91176
Redland IPA (Synermed)
2497
(437) 4284-1365,
extension 213
SYMED
ResourceOne Administrators
3257
Refer to Member's ID card
37278
RMSCO, Inc.
3272
Refer to Member's ID card
16117
Rooney Life, Inc.
6483
(317) 290-8100
37602
Saint Barnabas System Health Plan
1897
(732) 562-2834
22240
St. John's Claims Administration
3855
Refer to Member's ID card
37264
Saint Mary's Health Plan
4256
Refer to Member's ID card
88029
Saint Therese Physician Associates
1851
(630) 428-5397
37116
Sante Health System and Affiliates
2281
(559) 228-5479
77038
Scan Health Plan
4464
Refer to Member's ID card
72261
Seabury and Smith
6493
(319) 351-2667,
extension 5640
13310
Secure Health Plans of Georgia, LLC
3774
(800) 648-7563,
option 1 /
(478) 314-2437,
option 1
28530
Security Health Plan
5427
(715) 387-5983
39045
Select Benefit Administrators (Des Moines, IA)
1890
(800) 397-0427 /
(515) 223-7000
42137
Select Benefit Administrators of America
2747
Refer to Member's ID card
37282
Select Health of South Carolina
2890
(888) 394-3100
23285
SelectCare
7449
(800) 858-9060
00014
Self Funded Plans (IL, PA, OH)
6494
(216) 566-1455,
extension 116
34131
Self Insured Benefit Administrators (Clearwater, FL)
2213
Refer to Member's ID card
59111
Self Insured Plans (Naples, FL)
5471
(630) 428-5397
36404
Senior Whole Health
3443
Refer to Member's ID card
83035
Sentinel Management Services
3256
Refer to Member's ID card
23249
Shasta Administrative Services
3847
Refer to Member's ID card
75280
Sheet Metal Workers
4432
Refer to Member's ID card
TH047
Signature Care Health Network
2825
(888) 446-5847
35206
Signature Health Alliance
5497
(615) 460-7234,
extension 225
62159
Sinclair Health Plan
3886
(630) 789-2082
84076
Smith Administrators
3467
Refer to Member's ID card
02057
Southcare/Healthcare Preferred
3825
(800) 323-5000
25147
Southern California Children's Network
2497
(437) 4284-1365,
extension 213
SYMED
Southern Group Administrators
2229
Refer to Member's ID card
56131
Southern Health Systems, Inc.
1752
(412) 497-3690
25128
Southwest Service Life
3244
Refer to Member's ID card
37266
Special Risk International (SRI)
3745
(410) 321-7568,
extension 102
52190
Spina Bifida - VA HAC
3807
(800) 733-8387
84146
Star HRG
3885
Refer to Member's ID card
59225
Starmark
6401
(708) 615-1500,
extension 2135
61425
State Employees Group Benefits Program
1832
(225) 922-2856 or
(225) 925-3985
72087
State Farm Insurance Companies
5419
(309) 766-5564
31053
States General Life Insurance
5425
Refer to Member's ID card
75087
Stoner and Associates - Cincinnati, OH
2222
Refer to Member's ID card
31121
Student Insurance - MEGA Life and Health Insurance Company
6465
(800) 767-0700
74227
Student Insurance - Midwest National Life Insurance Co. of Tennessee
6465
(800) 767-0700
74227
Suffolk Health Plan of New York
2223
Refer to Member's ID card
88331
SummaCare Health Plan
1755
(330) 996-8400
95202
Sun Health Corporation
3454
Refer to Member's ID card
SX186
Superior Administrators, Inc. (Santa Ana, CA)
3760
(888) 429-9000
23218
Synermed
2497
(437) 4284-1365,
extension 213
SYMED
Tarrant Health Services
3752
(817) 740-8513
37228
Teachers Health Trust
1827
(702) 794-0272
88019
Teamcare
6492
(800) 325-5000
36215
Team Choice PPO
1822
(972) 980-0300,
extension 212
75133
Teamsters Local Union # 301
2876
(630) 789-2082,
extension 203
36612
Texas Children's Health Plan
1729
(713) 770-2422
76048
Texas Children's Health Plan (Medicaid)
2483
Refer to Member's ID card
75228
Texas Municipal League Group
6456
(512) 719-6500
74214
Third Party Administrators, Inc.
2842
(630) 416-1111
37225
Third Party Claims Management
3258
Refer to Member's ID card
06131
Time Insurance Company
6428
(414) 299-6317
39065
Todays Option
3233
Refer to Member's ID card
48055
Tooling and Manufacturing Association
6401
(708) 615-1500,
extension 2135
61425
Total Carolina Care
4272
Refer to Member's ID card
68055
Total Healthcare, Inc.
3852
Refer to Member's ID card
38201
Touchstone Health / Health Net Smart Choice
2224
Refer to Member's ID card
13402
Touchstone Health PSO
4737
Refer to Member's ID card
23856
Tower Life Insurance Company
5453
(210) 554-4565
69493
TPA Inc.
2842
(630) 416-1111
37225
TR Paul Inc.
3242
Refer to Member's ID card
37230
Trans Health Protection Plan
5402
(715) 841-7399
39026
TransAmerica Life Insurance Company
2892
(800) 527-2845
59222
Transchoice Key Benefit Administrators
3249
Refer to Member's ID card
37284
Trisurant
1847
(800) 242-8936
34185
TrustMark Insurance Company
6401
(708) 615-1500,
extension 2135
61425
UBH RIOS
2833
(763) 732-6174
16412
UICI - Administrators (State of Nevada)
6472
(800) 292-5386,
extension 227
74223
UNICARE
8473
(800) 543-4556,
extension 5661
80314
Unified Group Services
3838
Refer to Member's ID card
35198
Unified Health Services
5420
(901) 843-2667
62170
Uniform Medical Plan/Harrington Benefit Services
8404
(972) 301-8303
75243
Union Labor Life Insurance Company (The)
1426
(202) 682-0900
13142
Union Pacific Railroad Employee Health System
3724
(800) 547-0421 or
(801) 595-4300
87042
Union Security Insurance Company
1760
(800) 800-8463 or
(414) 271-3011
70408
United Healthcare (Plans)
3429
(800) 842-1109
87726
United Heatlhcare of the River Valley (Plans)
6442
(866) 509-1593 /
(309) 765-1593
95378
United Medical Alliance
1802
(970) 224-4600
84132
United Medical Resources
5408
Refer to Member's ID card
31107
United Mine Workers of America (UMWA)
1758
(888) 865-5290
52180
United Resources Network
3824
(763) 797-4871
41194
Universal Care - California
3836
Refer to Member's ID card
33001
Universal Health Care, Inc.
2405
Refer to Member's ID card
50528
University Family Care – Healthcare Group
2748
Refer to Member's ID card
07503
University Family Care - Maricopa Health Plan
2719
Refer to Member's ID card
09908
UPMC Health Plan - Commercial
2803
Refer to Member's ID card
23281
Upper Peninsula Health Plan
3741
(847) 887-8088
38337
US Benefits
2241
(800) 866-8318
93092
USAA (U.S. Automobile Association)
6477
(210) 456-2906
74095
USFHP - St. Vincent Catholic Medical Centers of New York
2845
(646) 230-2384
13407
Vanguard Health Systems
2497
(437) 4284-1365,
extension 213
SYMED
Vantage Health Plan
1816
(318) 361-0900
72128
Virginia Premier Health Plan
2245
Refer to Member's ID card
54176
Veteran's Administration Fee Based Programs
3887
Refer to Member's ID card
12115
VHP Community Care
2891
(800) 457-5683
23173
Vida Care
3466
Refer to Member's ID card
24818
Volusia Health Network
3239
Refer to Member's ID card
59266
Vytra Healthcare
8440
(516) 844-2640
22264
Watkins Associated Industries, Inc.
3756
(800) 333-3841
58082
Wausau Benefits, Inc.
5402
(715) 841-7399
39026
Wausau Preferred Health Plans
5402
(715) 841-7399
39026
Wells Fargo Third Party Administrators, Inc.
6410
(800) 888-5256 (FL) or (800) 888-2565
87815
Western Southern Financial Group (Cincinnati, OH)
2260
Refer to Member's ID card
37306
Western Mutual Insurance
3827
Refer to Member's ID card
37247
William C. Earhart
3465
(800) 547-1314 or
(503) 282-5581 / info@wcearhart.com
93050
William J. Sutton & Company, LTD - Toronto, Canada
2226
Refer to Member's ID card
98010
Windsor Medicare Extra
2294
Refer to Member's ID card
62153
Winhealth
4761
Refer to Member's ID card

Worksite Benefit Services
3243
Refer to Member's ID card
20333
World Insurance Company
2849
(800) 786-7557
75276
Writers' Guild Industry Health Plan
2847
(800) 227-7863,
option 2
23710
Young Life
3248
Refer to Member's ID card
75285

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

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How to learn billing without taking a college course

2008-11-11T13:45:00.000-08:00

From time to time I get questions from people who would like to be a medical biller but have no billing experience. They ask how do I learn what I need to know to complete these steps without having to complete a College course or a online class.

Simply put you have many options:
1. Purchase the most current AMA Physician ICD-9-CM 2009 book and read the Coding Guidelines (about 35 pages).

2. Purchase the most current CPT 2009 Professional Edition (Current Procedural Terminology, Professional Ed. and read everything about modifiers, Place of Service, Introduction, and Evaluation and Management Service Guidelines. Always familiarize yourself with the first page of the Guidelines of each section. This is what the doctors use to learn how to "code" for their services. It's best to familiarize yourself with this.

3. How To Complete A CMS 1500 Form Completely and Correctly - Line By Line, Box By Box: HCFA 1500 Instructions

4. Purchase books like Medical Billing & Coding Demystified to help you understand how to put this all together.

5. Read the Fair Credit Reporting Act http://www.ftc.gov/os/statutes/fcrajump.shtm to learn about the protection of Medical Information, patient credit checks.

6. Read the Fair Debt Collection Practices Act http://www.ftc.gov/bcp/edu/pubs/consumer/credit/cre27.pdf

7. Learn HIPAA http://www.hhs.gov/ocr/hipaa/ which explains how to handle patients information

As a medical biller you do not need to have coding certifications or certificates of passing a Medical billing college course. In fact, most companies won't hire you on until you have 6 months of medical billing experience. Learn what you can and advance within the companies as you understand more.

Happy Billing!

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

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Are Medicare payments looking smaller each month?

2008-11-10T19:15:00.000-08:00

Is your HPSA/PSA incentive payment less than you think it should be? One reason could be that the 5% Physician Scarcity Area (PSA) Incentive Payment ended recently. It was effective for dates of service from January 1, 2005, through June 30, 2008.

Any services rendered after June 30, 2008, will not receive the PSA incentive payment. This change does not effect the Health Professional Shortage Area (HPSA) incentive payment.

PSA Overview:
Medicare will automatically pay this new bonus on a quarterly basis without the need for a modifier on the claim for services provided in zip code areas that:
*Fall fully within a county designated as a PSA; or
*Fall partially within a county designated as a PSA and are considered to be dominant for that county, based on a determination of the United States Postal Service; or
*Fall within a rural area of a metropolitan statistical area identified through the latest modification of the Goldsmith modification that is determined to be a PSA.

In some cases, a service may be provided in a county that is considered to be a PSA, but the zip code is not considered to be dominant for that area. In these cases, the bonus payment cannot be made automatically. To receive the bonus for such services, physicians will need to include the AR modifier to reflect a physician service provided in a PSA.

Some key points to remember regarding the PSA bonus are the following:

*Medicare will pay a five percent PSA bonus on a quarterly basis, and the bonus will be based on what Medicare actually paid not on the Medicare-approved payment amount.
*A single service may be eligible for the PSA bonus and the HPSA bonus, which is discussed later.
*Payment will be based on where the service is performed and not on the address of the beneficiary.
*The PSA bonus will be paid on services rendered on or after January 1, 2005 through December 31, 2007.
*Only the provider designations of General Practice (01), Family Practice (08), Internal Medicine (11), and Obstetrics/Gynecology (16) will be paid the bonus for the zip codes designated as primary care PSAs. All other physician provider specialties will be eligible for the specialty physician scarcity bonus for the zip codes designated as specialty PSAs.
*Dentists, chiropractors, podiatrists, and optometrists are not eligible for the physician scarcity bonus as either primary care or specialty physicians.
*Medicare will pay a five percent PSA bonus on a quarterly basis, and the bonus will be based on what Medicare actually paid not on the Medicare-approved payment amount.
*A single service may be eligible for the PSA bonus and the HPSA bonus, which is discussed later.
*Payment will be based on where the service is performed and not on the address of the beneficiary.
*The PSA bonus will be paid on services rendered on or after January 1, 2005 through December 31, 2007.
*Only the provider designations of General Practice (01), Family Practice (08), Internal Medicine (11), and Obstetrics/Gynecology (16) will be paid the bonus for the zip codes designated as primary care PSAs. All other physician provider specialties will be eligible for the specialty physician scarcity bonus for the zip codes designated as specialty PSAs.
*Dentists, chiropractors, podiatrists, and optometrists are not eligible for the physician scarcity bonus as either primary care or specialty physicians.
*Services submitted with the AR modifier will be subject to validation by Medicare.

HPSA Overview:
MMA Section 413(b) requires CMS to revise some of the policies that address HPSA bonus payments. Section 1833(m) of the Social Security Act provides bonus payments for physicians who furnish medical care services in geographic areas that are designated by the HRSA as primary medical care HPSAs under section 332 (a)(1)(A) of the Public Health Service (PHS) Act. In addition, for claims with dates of service on or after July 1, 2004, psychiatrists (provider specialty 26) furnishing services in mental health HPSAs are also eligible to receive bonus payments. But keep in mind that if a zip code falls within both a primary care and mental health HPSA, only one bonus will be paid on the service.

MMA Changes
Effective January 1, 2005, you no longer have to include a modifier on claims to receive your HPSA bonus payment, which will be paid to you automatically, if you provide care in zip code areas that either:

*Fall entirely in a county designated as a full-county HPSA; or
*Fall entirely within the county, through a USPS determination of dominance; or
*Fall entirely within a partial county HPSA.

However, if you provide care in zip code areas that do not fall entirely within a full county HPSA or partial county HPSA, you must enter the AQ modifier on your claim to receive the bonus.

The following are the specific instances in which you will need to enter a modifier:

*When you provide services in zip code areas that do not fall entirely within a designated full county HPSA bonus area;
*When you provide services in a zip code area that falls partially within a full county HPSA but is not considered to be in that county based on the USPS dominance decision;
*When you provide services in a zip code area that falls partially within a non-full county HPSA;
*When you provide services in a zip code area that was not included in the automated file of HPSA areas based on the date of the data run used to create the file.

To determine if you qualify to automatically receive the bonus payment, you can review the information provided on the CMS Web site. The HRSA website should be reviewed for the most recent designations. Physicians may also use the HRSA website designations when making the decision on whether or not to include the HPSA modifier on their claims.
Some points to remember include the following:

*Medicare carriers will continue to base your bonus on the amount you are actually paid (not the Medicare approved payment amount for each service) and will pay you the ten-percent bonus on a quarterly basis.
*The HPSA bonus pertains only to physician's professional services. Should you bill for a service that has both a professional and technical component, only the professional component will receive the bonus payment.
*The key to eligibility is not that your beneficiary lives in an HPSA nor that your office or primary location is in an HPSA, but rather that you actually render the service in an HPSA.
*A single service may be eligible for both the HPSA bonus payments and the physician scarcity bonus.
*To be considered for the bonus payment, you must include the name, address, and zip code of the location where the service was rendered on all electronic and paper claim submissions.
*Physicians should verify the eligibility of their area for a bonus before submitting services with a HPSA modifier for areas they think may still require the submission of a modifier to receive the bonus payment.
*Services submitted with the AQ modifier will be subject to validation by Medicare.

Do I need to use the "AR" Modifier?Check the automated pay zip code lists under under Primary Care or Speciality links first. If your zip code is on either list, you do not have to use the "AR" modifier.

Do I need to use the "AQ" Modifier?Areas eligible for payment via the AQ modifier must be verified using your local Carrier Web Sites

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

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Voluntary Refunds to Medicare and how to process in your medical office

2008-11-04T17:28:00.000-08:00

As a biller you will come across times where Medicare overpaid and this can happen because of many different scenarios like:

Overpaid on a Claim
Patient wasn't treated but claim was submitted resulting in a need to refund
Claim was billed under wrong provider
Claim was double paid

If you ever find that you have received an overpayment from Medicare per your contract with medicare you are required to refund the overpayment ASAP. Voluntary refund checks payable to the Medicare program cannot be returned, regardless of the amount of the refund. If you need to refund Medicare, please verify you are sending the correct amount.

** WPS disclaimer: The acceptance of a voluntary refund in no way affects or limits the rights of the Federal Government or any of its agencies or agents to pursue any appropriate criminal, civil, or administrative remedies arising from or relating to these or any other claims.

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

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How to email Medicare with Personal Health Information

2008-11-04T17:22:00.000-08:00

Well, to begin with you should know straight off to never send Patient Health Information by email especially to Medicare since this is a HIPAA issue. However, Medicare breaks it down by additional information that they request doctors/billing services please do not send through email. Also find out what information you can send by email so Medicare can find your patient.

Do not send the Beneficiary's Health Insurance Claim Number (HICN)
Do not send Protected Health Information (PHI)

Examples:

Patient Name
Patient Date of Birth
Patient Social Security Number
Patient Medicare ID#

What to send to Medicare through Email:

They ask that you please only send the ICN or Internal Control Number for the claim in question. This is all of the information WPS Medicare requires in order to find the patients information on their side.

Please do your part to protect your patients health information.

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Crossover Error Code Notification

2008-11-04T17:17:00.000-08:00

If your providers received a crossover rejection letter dated October 17 2008 and containing rejection code N22223 please ignore these letters. These letters were sent in error and should be shredded.

WPS Medicare Part B accidentally sent Crossover Rejection letters dated on October 17th 2008 containing N22223 can be ignored and shredded. These were sent in error!

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

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Medicare Fee Schedules are not appealable

2008-11-04T16:39:00.000-08:00

Medicare has released a notification stating that they are receiving a higher volume in appeal requests for services which Medicare paid the claim appropriately based on the set allowable fee schedule.

WPS Medicare wants medical providers to understand that for those who noticed the fee schedule change resulted in a payment reduction and are attempting to appeal that this is not an appealable option.

Per the Centers of Medicare and Medicaid Services (CMS) internet-Only Manual (IOM) Publication 100-4, Chapter 29, Section 200 C (3). This section states, Actions that are not initial determinations and are not appealable under this the Chapter include, but are not limited to, "Any issue regarding the computation of the payment amount of program reimbursement of general applicability for which CMS or a carrier has sole responsibility under Part B, such as the establishment of a fee schedule set forth in 42 CFR, part 414, subpart B or an inherent reasonableness adjustment pursuant to 42 CFR 405.502 (g).:

Please refer to the CMS IOM 100-4, Chapter 29 regarding appeals at the following Website address:http://www.cms.hhs.gov/manuals/downloads/clm104c29.pdf

Medical billers/collectors please forward this information on to your providers that bill to Medicare so they are aware of these changes. When they ask you to "collect" more on these fee schedules you will be able to explain why you can't.

Good Luck and Happy Billing!

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

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SAMBA payor ID# 37259 will be consolidated under Cigna 62308 for RelayHealth

2008-11-04T16:23:00.000-08:00

If you use RelayHealth as your clearinghouse and bill SAMBA Payor ID#37259 CPID# 6502 you can immediately begin billing the SAMBA claims under CPID#4509.

CPID#4509 is Cigna Health Plans Payor ID 62308

The following changes will affect you:

RelayHealth will temporarily convert CPID# 6502 SAMBA to CPID# 4509 Cigna Health plans until December 3 2008
All claims for CPID# 6502 SAMBA can be submitted using CPID# 4509 immediately
The last date that CPID# 6502 will be accepted at RelayHealth is December 3 2008
Effective December 4 2008 all claims for CPID 6502 SAMBA must be submitted to RelayHealth using CPID 4509 Cigna Health Plans.

Please understand that if you do not update your CPID# by December 3rd for SAMBA your claims will begin getting denied by McKesson/RelayHealth on December 4th.

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

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Priority Health of Michigan adding a new EDI Report

2008-11-04T16:08:00.000-08:00

Priority Health of Michigan has added a new EDI report to their list. RelayHealth has programmed this report to be routed through it's clearinghouse system for existing users. If you bill Priority Health of Michigan and use RelayHealth as your clearinghouse you will see the new 277U report.

277U report Claim Status Response (is claim on file, was claim paid, why is claim pending)

This should help your medical billing and collections to identify the status of claims you submitted electronically through RelayHealth. This new report will be usable on October 31, 2008.

Additional Medical Billing and Codingquestions are answered here: Online Medical Coding and Billing Courses. You will also be able to get articles on EDI Reports, what they are, how to read them and the different types of reports including the 277 report.

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New updates to billing claims to Wisconsin Medicaid for November 10 2008

2008-11-04T15:50:00.000-08:00

Things keep constantly changing and if you miss it for a moment you may see your money stop immediately. This new update comes from Wisconsin Medicaid. If you are billing through RelayHealth (McKesson) it's CPID# 1476 and 5510.

As of November 10, 2008 Wisconsin Medicaid CPID# 1476 and 5510 will require NPI. ForwardHealth Interchange, Wisconsin Medicaid will require the NPI to be sent on claims. Providers will also need to send their Taxonomy code for both Billing Provider and Rendering Provider and also include their 9 numeric zip code.

Electronic Claim Submission:
As of November 10, 2008 if you send claims with the legacy Medicaid provider number it will be DENIED or rejected by Wisconsin Medicaid.
**Non-healthcare providers i.e, personal care only provider, specialized medical vehicle providers, community care organizations and blood banks will continue to use their 8-digit Medicaid Provider number.

Paper Claims:
All paper claims must be printed on the new CMS-1500 form or the UB-04 form or will be denied

Please be ready to send your NPI number for Wisconsin Medicaid and use the most current CMS-1500 forms.

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

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Consolidated DME MAC CPID#'s for RelayHealth updates

2008-11-04T15:46:00.000-08:00

Please be aware of CPID#'s that have been deleted from McKesson/RelayHealth Clearinghouse in regards to DME MAC Jurisdiction A, B, C and D.

Correction: CPIDs 4229 - 4232 have been removed as they do not apply.

RelayHealth has received notification of changes to the reports received from the following CPIDs:
7475 Medicare DME MAC Jurisdiction A
7476 Medicare DME MAC Jurisdiction B
7477 Medicare DME MAC Jurisdiction C
7478 Medicare DME MAC Jurisdiction D

Effective mid-November 2008 Medicare will be consolidating the reports they return from the DME MAC Jurisdictions. The rejections performed and returned on the Gen response report will be updated to handle edits currently being performed on the DME MAC Level II Report. The DME MAC Level II report will no longer be generated and returned to clients.

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DME MAC Dubuque and Chicago changes happening on EDI Reports

2008-11-04T15:41:00.001-08:00

RelayHealth has received notification of changes to the reports received from the following CPIDs:

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

Chicago
4229 Medicare DME MAC Jurisdiction A
4230 Medicare DME MAC Jurisdiction B
4231 Medicare DME MAC Jurisdiction C
4232 Medicare DME MAC Jurisdiction D

Effective Mid-November 2008 Medicare will be consolidating the reports they return from the DME MAC Jurisdictions. The rejections performed and returned on the Genresponse report will be updated to handle edits currently being performed on the DME MAC Level II Report.

***The DME MAC Level II report will no longer be generated and returned to clients.

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

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Kansas, Nebraska and Western Missouri Medicare Updates

2008-11-04T15:35:00.000-08:00

RelayHealth was updated with new information regarding Wisconsin Physicians Service (WPS) about processing change to the Part B processing system for Kansas Medicare, Nebraska Medicare, and Western Missouri Medicare. The WPS change will allow for consistent processing for the Jurisdiction 5 Medicare Administrative Contractor (MAC) and automate many of the current manual processes allowing for more accurate and timely payment. These new changes will benefit providers and medical offices.

The change will affect claims processed November 1, 2008 and after.

The payors affected are listed below:
CPID# Insurance Carrier Name
2463 Kansas Medicare
1451 Nebraska Medicare
4451 Western Missouri Medicare

RelayHealth has identified the following items for you to be aware of with this change:
WPS Medicare Part B will have a system dark day on October 31, 2008
No customer service activity. The Provider Call Center representatives will not have system access.

* Interactive Voice Response (IVR) access will be available for registered C-Snap users.
* RelayHealth will send claims to WPS on October 31, 2008; however, claim processing will not begin until Monday November 3, 2008.
* WPS will output reports on Tuesday November 4, 2008. RelayHealth will output reports when they are received from WPS.

Please review your reports and expect an initial delay in processing of claims.

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

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RelayHealth releasing new reports on Specific Insurance Carriers

2008-11-04T15:20:00.000-08:00

On Wednesday November 5th 2008 RelayHealth Clearinghouse (McKesson) will be changing the electronic claims routing for the following payors:

CPID Payor Name Payor ID
1705 Advantage Health 35209
2295 Allegiance Benefit Plan Management, Inc. 81040
2227 Allied Administrators (San Francisco, CA) 94177
2230 American Bene Mgt 34187
6436 American Postal Workers 44444
8456 Arcadian Mgmt Services 77045
3781 CA Kaiser North only KS003
3472 Cedars Sinai Medical Encounter 95167
6440 Connecticare 06105
5446 Custom Bene Admin 39170
2486 Delta Health System DHS01
8451 Emerald Health 34167
2898 Health Design Plus 34158
8431 Health Plan Services 59140
3231 Medical Bene Admin 68041
2239 Mercy Care Plus 71079
1782 North American Medical Management E3510
6417 Pacific Mutual 67466
2257 QuadMed 39197
2238 Trusteed Plans Service Corporation 91078
3224 UFCW Local 400-5205 UFC97
1735 Western Growers Trust 24735
5415 Western Southern Life Group 31048
3259 Wisconsin Auto and Truck Dealers 39200

*CPID# is the 4 digit # RelayHealth uses to know which insurance carrier you are submitting your claim for
*Payor ID# is the # listed on the back of the patients insurance card. Cross reference that # to find the CPID# to submit claims through RelayHealth.

Changes that will take place for these insurance carriers is:

Payor Agreements are not required
Daily CLaims - Verification Statement Report will be made available
Electronic Response Report will be made available
RelayHealth Standardized Payor Reports will be made available

Look for these changes starting tomorrow November 5th 2008

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

Tags: Insurance Carriers, Medical Claims, Billing Electronic Claims through RelayHealth Clearinghouse, Updated reports from clearinghouse, claim routing changes, new reports, 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, medical billing software, medisoft medical billing software, web based medical billing, degree medical billing, electronic medical billing, electronic medical billing software, medical billing education, medical insurance billing software, medical billing and coding course, medical billing online course, medical billing software company, learn medical billing, insurance billing software, medical assistant school, medical billing course, medical billing program, medical billing and coding software, edits, updates, ticklers, medical health insurance carriers, medical billing, coding, editing, fixing, rebilling, what to expect, system changes, notifications of updates, health insurance, facilities, medical offices, claim updates, new changes, healthy clean claim submission

How to start a medical billing service company?

2008-10-24T10:07:00.000-07:00

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.

www.medicalbillingsoftwarepro.com to research Practice Management Software Products and find the one that will work best for you and your company
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.
www.medicalbillingservicepro.com gives you ideas, suggestions and recommendations on how to start, operate and make money with a billing service.
Visit my website often for new updates to coding issues, billing claim denial reasons etc.
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

2008-10-24T09:52:00.001-07:00

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

2008-10-24T09:20:00.000-07:00

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

2008-10-24T08:34:00.000-07:00

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

2008-10-24T08:08:00.000-07:00

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:

Payor Batch Totals Report (SB)
Payor Batch Totals Data File (SD)
Payor Claim Data Report (SR)
Payor Claim Rejections Report (SE)
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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Vehicle Insurance Coverage Rates: What Makes Them Change?

2008-10-15T18:14:00.003-07:00

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!

2008-10-15T18:14:00.001-07:00

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

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

2008-10-13T13:57:00.000-07:00

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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Make money in your spare time while working from Home

2008-10-09T07:31:00.000-07:00

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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Make over $500 for Part Time work from Home

2008-10-08T12:05:00.000-07:00

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

Doctor Promotional Giveaways to increase patient business

2008-10-06T08:13:00.000-07:00

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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