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Statistics |
| Unique Visitors: 3 |
| Total Unique Visitors: 7264562 |
| Visitors Out: 1169 |
| Total Visitors Out: 13075 |
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| Electronic Claims Submission - introduction and benefits - can we use free software? |
| 2012-02-10 05:23:00 |
IntroductionSubmitting Medicaid claims via electronic media offers the advantage of speedand accuracy in processing. Providers may submit electronic claimsthemselves or choose a billing agent that offers electronic claim submissionservices. Billing agents must enroll as Medicaid providers.Benefits The benefits of electronic claims submission include:· Increase speed of claims payments, seven days in some cases.· Correct data entry errors immediately, avoiding mailing time and costs.· Eliminate the cost and inconvenience of claims paperwork.· Reduce office space required for storing claim forms, envelopes, etc.· Decrease mailing costs.· Decrease clerical labor costs.· Automate the office for a more efficient operation.Free Software ...
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| insurance claims submission and mailing checklist |
| 2012-02-06 05:20:00 |
Claims Submission ChecklistIntroduction Use the following checklist before submitting a claim to the fiscal agent for reimbursement.Checklist* Is the form typed or printed in black ink?* Is the copy legible?* Were instructions in the handbook followed? Some fields are not self explanatory or may be used for other purposes.* Are the provider name(s) and number(s) entered?* Is the claim signed and dated? Unsigned claims will be returned unprocessed.* Are attachments required? Claims cannot be paid without the required attachments.* Is the P.O. Box number for submitting the claim correct?Claims Mailing ChecklistIntroduction The following checklist may be used when mailing claims to the fiscal agent forreimbursement.Checklist* Enclose only one claim type pe...
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| claim timely filing denial exceptions. |
| 2012-02-02 05:15:00 |
The following scenario, claim will not be denied as timely filing limit exceeded.Exceptions to the 12-Month Time LimitExceptions to the 12-month claim submission time limit may be allowed if theclaim meets one or more of the following conditions:· New clean claim submitted within six months of the date of the void of theoriginal claim payment date;· Court or hearing decision;· Delay in recipient eligibility determination;· Medicaid delay in updating eligibility file;· Court ordered or statutory action; or· System error on a claim that was originally filed within 12 months from thedate of service.Any claim filed more than 12 months from the date of service that meets anexception must be sent to the area Medicaid office for processing,...
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| Medicaid claim submission time limit - primary and secondary claims |
| 2012-01-28 05:15:00 |
Timely Claim SubmissionMedicaid providers should submit claims immediately after providing services sothat any problems with a claim can be corrected and the claim resubmittedbefore the filing deadline.Clean Claim In order for a claim to be paid, it must be a clean claim. A clean claim is aMedicaid claim that:· Has been accurately and fully completed according to Medicaid billing guidelines.· Is accompanied by all necessary documentation.· Can be processed and adjudicated by the fiscal agent without obtainingadditional information from the provider.12-Month Filing LimitA clean claim for services rendered must be received by the Medicaid office orits fiscal agent no later than 12 months from the date of service.Date Received DeterminedThe date s...
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| New and Established CPT code list |
| 2012-01-07 04:06:00 |
New and Established Patient Services A new patient is one who has not received any professional services from a physician or from another physician of the same specialty who belongs to the same group practice, within the past three years. Providers must use procedure codes 99201, 99202, 99203, 99204, and 99205 when billing for new patient services provided in the office or an outpatient or other ambulatory facility. New patient visits are limited to one every three years, per client, per provider. An established patient is one who has received professional services from a physician or from another physician of the same specialty within the same group practice, within the last three years. Providers must use procedure codes 99211, 99212, 99213, 99214, and 99215 when billing for e...
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| New CLIA waived CPT list - 2012 |
| 2012-01-03 03:45:00 |
New Waived Tests Effective Date : January 1, 2012Implementation Date : January 3, 2012STOP- Impact to youIf you do not have a valid, current, Clinical Laboratory Improvement Amendments of 1998 (CLIA) certificate and submit a claim to your Medicare Carrier or A/B MAC for Current Procedural Terminology (CPT) code that is considered to be a laboratory test requiring a CLIA certificate, your Medicare payment may be impacted.CAUTION _ What you need to knowCLIA requires that for each test it performs, a laboratory facility must be appropriately certified. The CPT codes that the Centers for Medicare & Medicaid Services (CMS) considers to be laboratory tests under CLIA (and thus requiring certification) change each year. Change Request (CR) 7566, from which this article is taken, informs ...
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| CPT 99212, 99213 visit history |
| 2011-12-29 03:40:00 |
The only difference between the history requirements for a 99212 and a 99213 is the review of systems.For a level-II visit, you need one point to meet the data requirement, which is considered minimal. You can earn one point by ordering or reviewing lab, radiology or procedure reports, or simply by obtaining old records about the patient or obtaining history from someone other than the patient (e.g., a family member or caregiver). The data for a level-III visit is considered limited and requires a total of two points. You can earn two points by reviewing or ordering two different types of tests (e.g., a complete blood count and a chest X-ray). You can also earn two points by summarizing old records or discussing the case with another health care provider. Risk. The risk associate...
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| comparison of CPT 99212 & 99213 |
| 2011-12-27 03:31:00 |
CPT 99212 vs 99213There is set of Evaluation and Management Guidelines that appear every year that the provider must become aware of. There are several physicians who might be wondering whether to use coding 99212 or 99213 this will help you to go through any ecision making process that is conducted without much difficulty.The three things that one must keep in mind for the selection of the right E/M code are:1. History 2. Exam 3. Decision making When you consider CPT codes 99212 to 99215 they require that only two of the three key components meet or exceed the level of code that is chosen.The Review of Systems (ROS) is the key difference between a PF (99212) and an EPF (99213) history. The CPT 99212 does not require a ROS and documentation.The ROS is a list of signs or ...
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| CPT code 99354 – Prolonged Visit |
| 2011-12-24 03:30:00 |
CPT 99354 – Prolonged physician service in the office or other outpatient setting, requiring direct (face-to-face) patient contact beyond the usual service – first hour (List separately in addition to code for office or other outpatient Evaluation and Management service)The average reimbursement is in the range of $95.00, depending upon your region.The Medicare Manual says:The start and end times of the visit shall be documented in the medical record along with the date of service.This code is one of many under-utilized codes in your office for many reasons. However, if you do the work and spend the prolonged time, face to face with the patient, document the progress note properly and provide the required medically necessary components, you deserve to use this code a...
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| EHR incentive payment - How to register |
| 2011-12-21 03:28:00 |
Registration Eligible ProfessionalRegistration at the national level for the Medicaid EHR Incentive Program opened in January 2011. However, the Medicaid EHR Incentive Program is administered individually by each state, therefore registration start dates vary from State to State. Eligible professionals are required to register on the national level through the CMS website and at the state level in Florida. STEP1Register on the CMS Medicare and Medicaid EHR Incentive Program Registration and Attestation System.For the most up-to-date information about registration into the CMS Medicare and Medicaid EHR Incentive Program Registration and Attestation System click here.Eligible Providers will need to complete the following in order to complete registration:Meet the eligibility require...
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