Federal tax id number and accept assignment field on CMS 1500
Billing instruction for Ambulance Billing - Box 24h to 27BlockNo.Block NameBlock CodeNotes24hEPSDT/FamilyPlanningAEnter the 2-digit visit code, if applicable. Visit codes are especially important if...
View ArticleBlock 28 - 32b on CMS 1500 instruction
Billing instruction for Ambulance Billing - Box 28 to32bBlockNo.Block NameBlock CodeNotes28 Total ChargeLBDo not complete this block.29 Amount PaidAIf a patient is to pay a portion of their medical...
View ArticleHow to fill box 33 on CMS 1500
Billing instruction for Ambulance Billing - Box 33BlockNo.Block NameBlock CodeNotes33 Billing ProviderInfo & Ph.#A/A& M/MEnter the billing provider’s name, address, and telephone numberDo not...
View ArticleUsing BCBS clear claim connection
Clear Claim ConnectionYou can simulate the likely procedure code editing rules for your BCBSF claims prior to submission orafter receiving the remittance advice by using Clear Claim Connection;...
View ArticleSubmitting electronic claim to BCBS
Electronic Claims SubmissionElectronic claims must be filed through the Availity Health Information Network. You may access theAvaility Health Information Network directly or send your claims through a...
View ArticleSubmitting paper claim - BCBS
Paper Claims SubmissionFiling your claims electronically is both quicker and more cost effective. However, there may be timeswhen it is necessary to file paper claims. The CMS-1500 (or equivalent) and...
View ArticleCMS 1500 OCR - guidelines and tips for clean claim
Optical Character Recognition (OCR)BCBSF uses OCR scanning equipment to process paper claims. OCR is an automated system that readsand interprets the characters in each block submitted on the claim...
View Articlewhat document called as Medical records
Medical RecordsUnder certain circumstances, BCBSF will require routine clinical information or medical records for selectprocedures/situations. Providers must submit the necessary clinical information...
View ArticleCMS 1500 - Data requirements - quick review
Data RequirementsProviders must either submit a CMS-1500 (or equivalent) or UB-04 paper claim form with all theinformation that is required for original Medicare submission or file the required data...
View ArticleUB 04 - Data requirment - Important field
UB-04:• Provider name (field 1) • Discharge hour (field 16)• Type of bill (field 4) • Patient status (field 17)• Federal Tax ID number (field 5) • Revenue...
View ArticleMedicare supplement claims submission - BCBS
Medicare Supplement ClaimsMedicare Supplement claims should be filed initially to Medicare with BCBSF indicated as thesupplemental carrier. Medicare will usually automatically crossover claims to BCBSF...
View ArticleAdditional document required to process the claim.
Claim Documentation RequestsWhen additional documentation is required to process a claim, BCBSF will fax or mail a written request toyou. The request will include a letter and a routing sheet for a...
View ArticleCMS 1500 - Helpful Claims Filing Hints
Helpful Claims Filing HintsTo prevent claims processing and payment delays, follow the claims filing hints below:• Verify coverage. Groups often have changes in their health insurance benefit plans....
View ArticleUB 04 - claim submission hints
UB-04:* Field 56 is for the NPI of the Billing Facility/Provider* Field 76 is for Type 1 NPIs (Attending Provider)* Fields 78 and 79 are for Type 1 NPIs (Other Referring Provider)• Use the correct...
View Articlecorrected claim - replacement of prior claim & voiding prior claim in BCBS
Corrected ClaimsA corrected claim is a claim that has already been processed, whether paid or denied, and is resubmittedwith additional charges, different procedure or diagnosis codes or any...
View ArticleBasic requirement for complete claim - CMS 1500
Complete claims requirements• Member’s name• Member’s address• Member’s gender• Member’s date of birth (dd/mm/yyyy)• Member’s relationship to subscriber• Subscriber’s name (enter exactly as it appears...
View ArticleIn which field and Loop NPI will get printed CMS 1500 & UB 04 locator
How to submit NPI, TIN and taxonomy on a claimThe information below provides the location for NPI, TIN and Taxonomy on paper and electronic claims. See definitions in the UB-04 Data Specifications...
View ArticleCompletion of UB 04 claim - Additional information
Additional information needed for a complete UB-04 form• Date and hour of admission• Discharge date and hour of discharge• Member status-at-discharge code• Type of bill code (three digits)• Type of...
View ArticleCorrected claim submission of CMS 1500 & UB04
Claim correction/resubmitIf you need to correct and re-submit a claim, submit a new CMS-1500 or UB-04 indicating the correction being made.When correcting or submitting late charges on a CMS-1500,...
View ArticleAnesthesia claim submission - 24 G filed on cms 1500 and loop 2400 SV104
Reporting requirements for anesthesia services• One of the CMS-required modifiers (AA, AD, QK, QX, QY, QZ, G8, G9 or QS) must be used for anesthesia services reporting.• For electronic claims, report...
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