Modifiers 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, if you adjust the […]
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 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 […]
Continue readingA short definition of assignment is, “who gets the money | insurance check | EOB.” The insured is the beneficiary of the insurance. In order for you to receive the insurance payment from the insurance company, you need permission from the insured (or other authorized person usually the spouse or parent). Accepting Assignment The insured […]
Continue readingChiropractic services are part of the standard Medical Benefits Package available to all eligible Veterans. All paper claims (HCFA-1500) should be mailed to: VHA Office of Community Care PO Box 30780 Tampa FL 33630-3780 … where they will be converted into EDI (electronic) format. VA claims can also be sent electronically. The payor ID for VA […]
Continue readingSuperbills are a mainstay of the cash practice. They contain information that the patient can use file their own insurance claims. A major problem with a superbill is that since they are simply a printout on plain paper which means that they could be reproduced and fraudulent claims then submitted by the patient. That’s why […]
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