Ways to Improve Processes Related to QMBs
Proactive steps to identify QMB individuals you serve and to communicate with State Medicaid Agencies (and Medicare Advantage plans if applicable), can promote compliance with QMB balance billing...
View ArticleUB-04 Clean Claim Submission: Essential Fields and Requirements
UB 04 Clean claim submissionUB-04 clean claim submission - Minimum required fieldThe UB-04 form (previously known as the UB-92 and CMS-1450 claim forms) captures essential data elements for providers...
View ArticleCan we leave CMS BOX 32 AS blank
Answer is Yes, read below32 Line 1Service Facility NameRequired if Service Facility Location is present in 32aEnter name of service facility only if Service Location is different than Billing Provider...
View ArticlePart A/B 5010 Electronic Claims: Documentation Submission
Electronic Billing Guide: Submitting Medical Documentation for Part A/B 5010 Electronic Claims Submitting Medical Documentation For Part A/B 5010 Electronic ClaimsUnder the Health Insurance Portability...
View ArticleCMS-838 Credit Balance Report: Instructions for Medicare Providers
Medicare Credit Balance Report – Provider InstructionsGeneralThe Paperwork Burden Reduction Act of 1995 was enacted to inform you about why the Government collects information and how it uses the...
View ArticleUnderstanding IEA, GS, and GE Segments in Interchange Control Trailers
This segment defines the end of an interchange of zero or more functional groups and interchange-related control segments.The Input Data column below contains text entered in [bracketed italics]...
View ArticleNavigating Resubmission Code 7: A Comprehensive Guide
Medical billing is a complex and intricate process, often fraught with challenges and nuances that can leave even the most seasoned professionals scratching their heads. Among the many codes and...
View ArticleRevolutionizing Medical Care: CPT 0075T-0076T Endovascular Therapies
In the ever-evolving landscape of medical treatments, precision and innovation are paramount. As we delve into the intricacies of endovascular therapies, we uncover the remarkable advances that have...
View ArticlePregnancy CPT Codes: Enhancing Prenatal Care
In the realm of healthcare, providing expectant mothers with optimal prenatal care is not only a moral imperative but also a crucial step in ensuring a healthy pregnancy journey. Prenatal care involves...
View ArticleCMS-1500 Form Item 33: Billing Provider Information and Requirements
BlockNo.Block NameBlock CodeNotes33Billing ProviderInfo & Ph.#A/A& M/MEnter the billing provider’s name, address, and telephone numberDo not use slashes, hyphens, or spaces.Note: If services...
View Articlebox number 1 - 4 - How to fill and instruction - upperright hand portion...
CMS-1500 Claim Form Completion for Ambulance ProvidersYou must follow these instructions to complete the CMS-1500 claim when billing the Department of Public Welfare. Do not imprint, type, or write...
View ArticleCMS 1500 Field 24A Date(s) of Service - How to print
DescriptionEnter the date the service was provided in MMDDYYYY format.For a Single Date of Service:In the “From” column, enter the date the service wasprovided in MMDDYYYY format. Leave the “To”...
View ArticleEfficient Drug Billing: Navigating CMS-1500 and UB-04 Forms
Drug Billing on CMS 1500 AND UB 04 -• Drug Billingo Providers are required to bill GHP with the applicable NDC and CPT/HCPCs codes for drugs.** Reporting NDC on a CMS-1500 claim form• Enter the NDC in...
View ArticleUnderstanding CMS 1500 Box 17-19: Ambulance Billing Guidelines
Box 17 - 19 - Reserved for local use - cms 1500Billing instruction for Ambulance Billing - Box 17 to 19BlockNo.Block NameBlock CodeNotes17Name of Referring Physician or Other SourceMEnter the name and...
View ArticleEfficient HCPCS Drug Code Submission in CMS 1500 for Accurate Billing
HCPCS Drug code submission in CMS 1500Billing of HCPCS Drug CodesTo submit a claim for a HCPCS Drug Code, complete field 24 as follows:• Field 24D – Enter the HCPCS Drug Code in the primary field...
View ArticleUnderstanding CMS1500 Box 19: NDC Requirements for J Code Billing
CMS1500 - BOX 19: RESERVED FOR LOCAL USEIf you are billing a J code in Box 24D, enter the NationalDrug Code (NDC) for that drug. Do not enter the descriptionof the drug, and do not enter NDC before...
View ArticleAT05, AT99, AT26 Adjustment Remark Codes and Billing Instructions
AT 05, AT99, AT26 adjustment remark codesBilling instruction for Ambulance BillingNote : When using “AT05”, indicating a Medicare payment, please remember to properly complete and attach the...
View ArticleINSTRUCTIONS FOR COMPLETING THE CMS 1500 MEDICARE ATTACHMENT
CMS 1500 Medicare Attachment SummaryPlease use this form in lieu of attaching the Medicare Explanation of Benefits (EOB) when billing. All the fields on this form must be completed in order to process...
View ArticleEfficient Claim Filing Procedures for Keystone Mercy Health Plan
Claim Filing Procedures for Claim SubmissionKeystone Mercy Health Plan, hereafter referred to as the Plan, is required by State and Federal regulations to capture specific data regarding services...
View ArticleInstruction and Guide: Rejected claim and denied claim
Rejected claims are defined as claims with invalid or missing data elements, such as the provider tax identification number, member ID number, that are returned to the provider or EDI* source without...
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