ABC Presentation
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Invalid member name, date of birth or identification number
Insurance claim rejections and its followup Invalid member name, date of birth or identification number Policy canceled or coverage terminated Invalid or obsolete ICD 10 diagnosis code Non specific ICD code posted for CPT 93306 External cause code cannot be used as Principal Diagnosis code Relations...
2021 E&M update
E&M code updates of 2021 Medicare and Medicare Advantage plans are adopting the new E&M codes starting from 01/01/2021. However commercial insurances usually follow CMS and AMA guidelines, they are not required to adopt the new changes. Key takeaways 99201 and 99211 are obsolete for 20...
How to avoid medical records request from UHC
How to avoid medical records request from United Healthcare United Healthcare requests medical records for most of the claims. After our deep analysis we found that if the total claim charge amount is more than $1,300 UHC is requesting medical records. We tried two claims for different patients with...
Fee Schedule
Fee schedule analysis and auditing The insurance allowed amount or the fee schedule is determined by various factors such as insurance plan, provider in-network or out of network status, ACO, PHO, geographic practice cost index, e...
Telehealth billing guidence for COVID
Telehealth CPT codes and COVID-19 CPT codes CPT Codes for COVID-19 testing U0001: Used specifically by the CDC for testing patients for COVID-19U0002: Allows laboratories to bill for non-CDC lab tests for COVID-1987635: SARS-CoV-2 (COVID-19); amplified probe technique (naso-pharyngeal swab) ICD Co...