Here are some basic things you must understand about billing Medicare for services to a patient that is or may be covered by liability insurance: Any liability coverage is the primary coverage – Medicare is secondary. You must wait 120 days from the date of service before you can bill Medicare (the promptly period). Any […]
Continue readingZero State Before you begin treating patients, you should setup the structure of your practice. First off, you should decide if you want to incorporate. A corporation provides a layer of protection for your assets. The laws governing incorporation vary state to state and there are multiple types of corporations so this decision should be […]
Continue readingModifiers are used to indicate that a service or procedure that has been performed has been altered by some specific circumstance but has not changed in its definition or code. Under normal circumstances, an Evaluation and Management service (E/M – exam) is filed without a modifier (99203 in this example). However, […]
Continue readingA Medicare overpayment is a payment that exceeds amounts properly payable under Medicare statutes and regulations. When Medicare identifies an overpayment, the amount becomes a debt you owe the Federal government. Federal law requires the Centers for Medicare & Medicaid Services (CMS) to recover all identified overpayments. Medicare overpayments commonly occur due to: Incorrect coding […]
Continue readingWhen a vehicle is rented, the person renting the vehicle can purchase insurance from the rental company or use their own insurance. At the time of the rental, the person or persons who will be operating the vehicle are identified (or designated) to the rental company. If your patient has been injured by a rented […]
Continue readingAll office records, test results, x-ray films etc. are the property of the clinic. The doctor is required by law to maintain the records for a period of time after the course of treatment has expired. Patients may request and are entitled to copies of their records but not the originals. This includes x-rays! Typically, the […]
Continue readingThe Medicare Beneficiary Identifier (MBI – which replaces the patient’s social security number) uses numbers 0-9 and all uppercase letters except for S, L, O, I, B, and Z. These letters have been excluded to avoid confusion when differentiating some letters and numbers (e.g., between ‘0’ and ‘O’). You should start using the new MBI […]
Continue readingThe chiropractic manipulative treatment (CMT) includes a pre and post service evaluation. The insurance companies, to their advantage, interpret this to mean that the “pre and post service” constitutes an Evaluation and Management service. When a CMT and E&M occur on the same visit/day, they will generally pay the least expensive service (the CMT) and […]
Continue readingInsurance companies use optical scanners to read paper claim forms and convert the information on them into an electronic format. This prevents the claim from having to be keyed into the computer by hand. Scanners can read approximately 2500 claims per hour and they have a 97 to 98 percent accuracy rate. Claims must meet […]
Continue readingWhen completing claims for most insurances, item 14 is for the date of onset – the date that the patient’s problem began and this date should be qualified with the qualifier 431 – Onset of Current Symptoms or Illness (The only other valid qualifier for item 14 is 484 – Last Menstrual Period) And item 15 is used […]
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