Download 2012 New Licensee Orientation INSURANCE CODING

North Carolina Board of
Podiatry Examiners
2012 New Licensee Orientation
INSURANCE CODING
June 23, 2012
NCBPE 2012 New Licensee Orientation
Insurance Coding:
Getting Started – Nat’l Provider #

#1 Obtain your NPI – necessary to bill Medicare or
obtain credentialing
◦ www.cms.hhs.gov /provider enrollment (Center for
Medical Services or Medicare)
◦ You may begin seeing Medicare patients before receiving your
NPI#, but you may not send in claims until you have been assigned
your Medicare NPI#.

Requires:
◦ Copy of NC license
◦ Copy of malpractice cover sheet
(minimum of $1mil/$3mil coverage)
◦ Copy of DEA with NC address
NCBPE 2012 New Licensee Orientation
Insurance Coding:
Getting Started – DME
To dispense durable medical equipment in your office:
 you must also apply for credentialing with Palmetto GBA (the
new contractor for NC Medicare DME)
www.palmettogba.com/palmetto/palmetto.nsf/DocsCat/Home

DME claims cannot be filed on the same Medicare form,
whether paper or electronic, as office visits, x-rays, procedures,
etc.
◦ These claims are processed by a different group and will be rejected
if sent to the standard NC Medicare address in Nashville, TN.

If you are joining an established practice, you do not need to be
credentialed if your facility is already credentialed by
Medicare DME.
NCBPE 2012 New Licensee Orientation
Insurance Coding –
Getting Started – Other Ins. Cos.
To apply to participate with other insurance carriers:

Download Uniform Application To Participate as a
Health Care Provider
http://www.ncdoi.com/LH/Documents/Licensing/Cre
dentialingApplication.pdf (14-page document) or

Go online to any of the specific insurance companies
and follow instructions

You must have acquired your NPI #.
NCBPE 2012 New Licensee Orientation
Insurance Coding –
PECOS
Provider Enrollment, Chain &
Ownership System (Internet-based
PECOS)
https://pecos.cms.hhs.gov/pecos/login.do
Use
in place of Medicare enrollment
application (i.e., paper CMS-885) to:
•
•
•
•
•
•
•
Submit an initial Medicare enrollment application
View or change your enrollment information
Track your enrollment application through the web
submission process
Add or change a reassignment of benefits
Submit changes to existing Medicare enrollment information
Reactivate an existing enrollment record
Withdraw from the Medicare Program
NCBPE 2012 New Licensee Orientation
Insurance Coding – Advantages
of Internet-Based PECOS

Faster (45 days vs. 60 days for paper)

Tailored application process means you only supply
information relevant to YOUR application

More control over your enrollment information,
including reassignments

Check and update your information for accuracy

Less staff time and administrative costs to complete
and submit enrollment to Medicare
NCBPE 2012 New Licensee Orientation
Insurance Coding –
PECOS is Easy!
Visit the Medicare Physician and NonPhvsician Practitioner Getting Started
Guide:
http://www.cms.gov/MedicareProviderSup
Enroll/downloads/GettingStarted.pdf


Problems or Questions? FAQs and
internet resources are contained within
document.
NCBPE 2012 New Licensee Orientation
Insurance Coding –
Other Insurance Companies.

Largest insurance carriers in NC:
◦
◦
◦
◦

Third-party administrators who contract directly with doctors
and hospitals as an umbrella organization for many
other insurance companies. Largest include:
◦
◦
◦
◦
◦

BCBS/NC
United Healthcare
Aetna
Cigna
Medcost
PHCS
Coventry
FirstHealth
CCN
You will receive a discounted fee schedule as a participant.
NCBPE 2012 New Licensee Orientation
Insurance Coding –
Other Insurance Companies
To participate with an insurance plan means:
lower fee for your services (set by the insurance
company)
insurance
payments coming directly to the
physician, not to the patient
incentives to the patients to use physicians
who participate (no out-of-network deductibles
to be met by the patient)
physician's name
being listed in patient's
insurance booklet and on insurance
website
NCBPE 2012 New Licensee Orientation
Insurance Coding - Resources
You must maintain current manuals to stay
in compliance with CMS (Center for
Medical Services or "Medicare"):
 ICD-9 (International Classification of Diseases) and
 CPT (Current Procedural Terminology)
◦ Available from:
AMA https://catalog.amaassn.org/Catalog/home.jsp
Ingenix http://www.ingenix.com/
(arm of UnitedHealthCare)
Medical Arts Press
http://www.medicalartspress.com/
NCBPE 2012 New Licensee Orientation
Insurance Coding –
Learning the Rules of Coding
Vital! Learn the rules of coding from the very
beginning of practice to stay in compliance and
to get paid.
 Advisory publications are ideal for:

insurance appeals,
staffing,
setting financial benchmarks,
establishing other revenue streams in your practice,
etc.
NCBPE 2012 New Licensee Orientation
Insurance Coding –
Learning the Rules of Coding cont’d

Attend a podiatry-specific coding seminar
◦ McVey Associates Coding Seminars www.mcveyseminars.com
◦ Cigna/Medicare sponsored workshop (1-866-238-9651)
http://www.cms.gov/home/medicare.asp?
◦ Contexo Media http://www.codingbooks.com/education/medicare/

Other Online Resources:
◦ “Codingline” www.codingline.com/trial.htm for trial issue or
email Dr. Harry Goldsmith at [email protected] for
information about the podiatry-specific coding digest where doctors
and billers can email specific coding questions they encounter in
their practices.
◦ www.podiatrvmanual.com CPT descriptions, CCI edits, modifiers,
E/M guidelines. Easy to use.
◦ www.donself.com Extensive medical management information.
NCBPE 2012 New Licensee Orientation
Insurance Coding –
Other Useful Websites

Advance Beneficiary Notice (ABN)
◦

American Medical Association (AMA)
◦
http://www.ama-assn.org/
Centers for Medicare & Medicaid Services (CMS)

◦
http://www.cms.gov/
CMS Correct Coding Initiative

◦
http://www.cms.gov/NationalCorrectCodInitEd/
CMS Physician's Information Resource for Medicare

◦

http://www.advancebeneficiarynotice.net/
◦
http://www.cms.gov/center/physician.asp
Evaluation and Management Documentation Guidelines
http://www.cms.gov/MLNEdWebGuide/25_EMDOC.asp
Federal Register

◦
http://www.federalregister.gov/
HIPAA

◦
http://www.hipaa.org/
National Provider Identifier

◦
https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.npistart
NCBPE 2012 New Licensee Orientation
Insurance Coding Insurance Terms
CMS (old term is HCFA): The federal government agency that sets
the industry standards for coding.
Primary
Insurance Carrier: If a patient is covered by
two insurances, the primary insurance has the primary responsibility
for payment, and thus pays the major portion of the patient's fees and sets
the fee rate for that DOS (date of service). Co-ordination of Benefits
(COB) prevents double payments ideally. Realistically, many errors are
made, and overpayments must be refunded or they are recouped by the
insurance plan.
Secondary
Insurance Carrier: The second payor which
may pick up 20%, the co-pay, and/or the deductible which was not paid by
the primary insurance plan.
EOB/EOP: Explanation of Benefits or Explanation of Payments.
Statement from the insurance plan with indicates amount paid, discount or writeoff amounts to be taken, patient responsibility amount, and reason for
payment denials.
NCBPE 2012 New Licensee Orientation
Insurance Coding Insurance Terms cont’d
Deductible: The amount required by an insurance plan to be paid by
the patient before the insurance benefits "kick in." Ex: Medicare's deductible
is $165 beginning each calendar year; BCBSNC deductible is $350 beginning each
July 1.
Participating Provider: A doctor who contracts with an insurance plan or
3rd party administrator (a company—MedCost, Coventry, PHCS--which negotiates
for many insurance plans under its umbrella) as a preferred provider in exchange
for a lower fee schedule and adherence to insurance company rules, such as the
appeals process, limitations on covered services, etc.
Referrals: Authorizations required by an insurance plan from a patient's PCP
in order for a patient to have his visit with a specialist paid by the insurance plan.
Referrals are needed for all HMO plans.
Global Surgical Periods: Time period during which you may not bill the
patient for follow-up care relating to the same diagnosis after a procedure
(surgery, cast, injection) has been rendered. Minor surgery has a 10-day global;
major surgery, a 90-day global. Procedures and office visits for problems other than
this previous diagnosis must use a -24 or -79 modifier.
NCBPE 2012 New Licensee Orientation
Insurance Coding Insurance Terms cont’d
CCI:
Correct Coding Initiative (part of the CMS rulings): Some
procedures cannot be billed together because they are mutually exclusive
or are considered bundled codes. Again, modifiers, in many instances, can
be used to bill multiple procedures not otherwise billable.
Pre-Existing:
This is an insurance, not a medical, term. It means
"Has this patient had continuous coverage with no break in coverage for
more than 61 days?" If a patient comes to you with a medical problem
that he has had before he saw you, but he has had continuous insurance
coverage, usually there is no problem. However, if that patient has had a
break in coverage longer than 61 days, then he must wait - usually one
year - before insurance relating to that diagnosis will be covered.
“Not
Medically Necessary”: Insurance talk that means an insurance
plan does not choose to cover or pay for a particular service whether it's
needed or not according to the doctor. Example: Eyeglasses are
"medically necessary" for many of us but are often listed in the
policy manual as "non-covered, medically unnecessary." This example
helps when explaining this concept to patients.
NCBPE 2012 New Licensee Orientation
Insurance Coding Insurance Terms cont’d
Diseases – 9thRevision) A
method of translating medical terminology to symptoms and diagnoses
by assigning them a numerical description. ICD-9 codes are 3,4, or 5
digits. It is important to code to the fifth digit when indicated.
ICD-9 (International Classification of
CPT (Current Procedural Terminology): A 5-digit description
of
every service and/or supply provided in a medical setting. The codes
are grouped by type and specialty: E/M, radiology, lab, surgery (by
body system), anesthesia, injectibles, DME, etc.
Multiple Procedures: Payment
by insurance plans when more than
one procedure is performed on the same patient on the same day: t he
1st procedure is paid at 100% of fee allowable,; the 2nd at 50%; 3rd, 4th,
5th, etc. , a t 50%, 25% or not at all, according to the insurance plan.
NCBPE 2012 New Licensee Orientation
Insurance Coding Insurance Terms cont’d
BCBS
Blue Card Program: Reciprocity of BCBS coverage
among the states. The out-of state claim is sent to your local
BCBS office where it is processed, then sent to the home state
plan for payment, which may come from the home plan or
come back from your local BCBS plan. Coverage issues are
determined by the home plan. Many in-state employers use
Blue Card plans: Wal-Mart, IBM, K-Mart, etc.
DME
(Durable Medical Equipment): Orthotics, night
splints, cam walkers, wheel chairs, post-op shoes. Many
insurance plans have separate rules and deductibles for DME.
Medicare claims go to a separate insurance carrier. With
Medicare, a solo doctor or group must have a DME
number that is different than the NPI and the doctor must be
credentialed by DME, separate from his credentialing with
"regular" Medicare.
NCBPE 2012 New Licensee Orientation
Insurance Coding Insurance Terms cont’d
Modifiers: You MUST learn them to survive.
The T codes indicate toes. Other modifiers keep CPTs from being
denied by computer software programs that would otherwise deny a
procedure under the CCI bundled rule.
TA=L1, T1=L2, T2=L3, T3=L4, T4=L5, T5=R1, T6=R2, T7=R3, T8=R4, T9=R5;
17110 needs a KX for Medicare & Aetna
Commonly used modifiers:
-25 Separate E/M on same day as a procedure
-59 Separate procedure on same day as a visit
-24 Unrelated E/M during a global period
-79 Unrelated procedure during a global period
-58 Staged procedure by same physician during post-op period
-80 Assistant surgeon
NCBPE 2012 New Licensee Orientation
Insurance Coding Insurance Terms cont’d
Place
of Service:
Numerical description of where service took place:
◦11
◦21
◦22
◦24
◦12
◦31
◦32
◦33
Doctor's office
In-patient hospital
Out-patient
Ambulatory Surgery Ctr.
Patient's home (for all DME)
Skilled nursing facility
Nursing facility
Custodial care facility
NCBPE 2012 New Licensee Orientation
Insurance Coding - Medicare
A federal
program with local regulations--What may be a covered service in
NJ may not be covered in NC, essentially what qualifies as Routine Care.
The
CMS (Medicare program) sets the fee basis for fees for the
entire industry; e.g., Insurance Company A will say it pays 115% of MCR
rate, etc.
Participating &
non-participating physician fee schedules are different. If you
are non-participating, all fees paid by Medicare go directly to the patient and
not to the doctor.
There are several Medicare hybrids:
◦Railroad Medicare (through Palmetto carrier in NC),
◦Union Medicare,
◦Medicare for DME which in NC is filed separately, and
◦the new, ever-changing ,private Medicare HMO (Advantra plans) such as:
Secure Horizons,
PacificCare,
BCBS Medicare,
Private Cigna Medicare,
Evercare,
Aetna Medicare, Cigna MCR, BCBX-MCR
These private Medicare programs often have different rules than "government- issue"
Cigna Medicare (in NC).
NCBPE 2012 New Licensee Orientation
Insurance Coding – Medicare cont’d

Custom orthotics (unless attached to a brace) are not covered by Medicare; neither
are many other items despite what your patients say. Cam walkers & night splints are
covered but are diagnosis-dependent.

Always get a waiver with an unna-boot because Medicare is very Dx-specific in their
coverage of unna-boots.

Correct coding should yield PR (pt responsibility) denial codes rather than
CO(contractual obligation: do not charge to patient) denial codes.

Redeterminations (lst level of appeal in Medicare) must be in writing to Cigna within
90 days of DOS (date of service).


Return Medicare overpayments quickly.
Medicare uses modifiers (KX=medically necessary and Q=qualified routine care) that
are not used by other insurances. You must learn and use these codes correctly to get
paid.
NCBPE 2012 New Licensee Orientation
Insurance Coding –
Medicare – Routine Care Coverage
Procedure
Diagnosis
11055
1. Diabetes or PVD Q7, Q8, Q9
2. Skin Diagnosis
11056
Modifier
Note
11057
11719
G0127
Pt. should be seeing
an MD for
underlying systemic
disease
1. Diabetes or PVD Systemic DX must always be listed first
2. Nail Dx
Block 19 must have MD’s name, NPI & DLS (pt’s date last seen-month/year)
The systemic diagnosis must always be listed first.
11720
11721
110.1 (primary
Diagnosis) mycosis
Must have 1of these for
2nd diagnosis: 729.5,
781.2, 681.11, 681.10,
719.77
Must have clinical
evidence of mycosis in
notes
It is not necessary to get a Medicare Waiver signed for non-covered routine care. The pt.
must be told that visit/procedure is not covered. If pt. insists that visit be filed to insurance,
b/c of secondary coverage, use the GY modifier.
If you are not sure if a particular visit/procedure will be covered, have pt. sign Medicare
waiver and use the GA modifier.
NCBPE 2012 New Licensee Orientation
Insurance & Billing –
Office Policies

Patient insurance cards –
◦Scan or make copies
◦Date front & back.
Without
an insurance card, a patient is self-pay.
Determine
while the patient is there which insurance is primary,
secondary, and/or tertiary if there is more than one insurance.
Upon
each return to the office, ask the patient if there has been a change
in their insurance.
If
a patient's insurance requires a referral, and the referral has not yet
come in, ask the patient to call his/her PCP or make patient a self-pay.
If
the visit is more than routine, check for benefits.
If
the patient is an Aetna HMO, make sure the referral has 99499
(consult AND treat) on the referral form.
NCBPE 2012 New Licensee Orientation
Insurance & Billing –
Office Policies cont’d
 Prior to
surgery, call to check eligibility and benefits,
including pre-existing, deductible information, facility
limitations, co-pays, and document everything.
 Your
biller or office manager must be carefully checking over
every EOB (Explanation of Benefits). Your office may be
dealing with at least 100 insurance plans. Be sure that the
carrier is paying the correct amount for a procedure or office
visit. It is extremely important to find out the reason for zero
pays or denials.
 Hire
someone with experience for your insurance department.
Do not skimp on salary at this position. Someone who writes
off everything the insurance company would like you to writeoff will cost you plenty - thousands of dollars, so don't be
penny-wise & pound-foolish.
NCBPE 2012 New Licensee Orientation
Insurance & Billing –
Office Policies cont’d
Document
all phone calls to insurance companies concerning
claims (date & reference #)
◦Avoid untimely filing denials.
◦Filing time limits vary from 90 -365 days.
(UnitedHealthCare is 90 days; Medicare is 365 days)
◦You will be penalized with a late fee for late filing.
File
all EOB's or information received by insurance companies
about individual claims by date.
◦You should be able to readily reference back to two years, and
preferably three.
Be
careful to send "clean claims"
◦Do not send our incorrect claim information. It is much better to
hold a claim to ensure that information is correct than to quickly
send out a claim with incorrect information.
◦Once an incorrect claim gets into the insurance computer's "black
hole", the account can and often does go quickly "south".
NCBPE 2012 New Licensee Orientation
Insurance & Billing –
Office Policies cont’d
Use
the insurance company's own appeal or medical review form
whenever possible.
◦Be persistent in your appeals
◦Oftentimes, more than one level of appeal is needed.
◦Do as many as needed--the insurance company is counting on you giving
up.
Accept
credit cards even though there is, of course, a fee involved.
Supplies
Ideally,
should always be paid at check out, never charged.
your accounts receivable (A/R) should be no more than 45
days.
◦Consider setting up payment plans for people who are unable to pay
their entire balance.
NCBPE 2012 New Licensee Orientation
Insurance & Billing –
Office Policies cont’d
Make copies
of everything that goes out of your office.
◦Maintain encounter forms for at least two (2) years where you can readily
reach them
◦In storage for seven (7) yrs.
Our
office copies all patient & insurance checks as well as patient
cash.
◦We keep copies of the sign-in sheets because we have people swear that
they were not in our office on a certain day. We scan all referral forms, Rx,
disability forms, etc.
Perform random chart and
accounting audits.
◦Check that all that was billed was documented
◦Check that all that was documented was billed.
◦Check encounter forms daily against computer charges to ensure that all
charges were entered and that the appropriate doctor was given credit.
NCBPE 2012 New Licensee Orientation
Miscellaneous CPT & ICD-9
Insurance Tips

Most insurances will not pay for an injection & a strapping on the same foot on same
date of service.

MCR, BCBS, UHC will not pay for two different injections on the same day.

17110 & 17111 (destruction of lesion by any means): These codes aren't paid unless
pain (729.5), erythematous condition (695.89), pruritic condition (698.9), disturbance of
skin sensation (782.0), or dermatitis (692.9) is the secondary diagnosis and this diagnosis
is noted in the chart.

Medical record notes must always be signed, manually or electronically.

Wound Care: Use the 11040 series (11043 & 11044 have a 10-day global) or CPT 97597
(wound care) series. Notes or Op. Report should note the extent of tissue level debrided.
Abscess deep in the foot, use 28003 (below fascia regardless of tendon involvement). If
osteomyelitis is present, code 20000 (superficial abscess incision, 2ndary to osteo) or
20005 (deep/complicated abscess,2ndary to osteo).

Medicare does not pay for post-op shoes.

Medicaid does not pay for DME (durable medical equipment).
NCBPE 2012 New Licensee Orientation
Miscellaneous CPT & ICD-9
Insurance Tips cont’d

Proximal plantar fascia injection: Use 20551 (not 20550).

Consult with the doctors in your practice or CPT journals to distinguish
among 64640, 64450, and 20550 for neuroma injection codes.

For Medicare: Do not utilize different CPT injections (i.e., 20600, 20605,
20550) on the same day, but you may perform two like injections on the
same DOS.

Use the KX modifier for Medicare to indicate that a procedure is
medically necessary.

Use E codes for a patient return as a result of patient re-injurying
operative site.
NCBPE 2012 New Licensee Orientation
Miscellaneous CPT & ICD-9
Insurance Tips cont’d

Use V code for personal hx of malignancy (reason for biopsy), for
long-term use of Lamsil., or to indicate amputation status.

Make sure you know if your patient requires in-office
authorization for certain procedures, esp. Aetna patients, before
you begin a procedure. Retro-authorizations are no longer given
by insurance companies.

If external fixator adjusted in office post-op, no charge. If return
to OR, then bill 20693-58.

Medicaid does not prescribe to the same use of modifiers as other
insurances; you cannot use RT or LT (right, left) and bilateral
procedures must have a 50 modifier but be listed as 1 unit.
NCBPE 2012 New Licensee Orientation
Insurance Coding –
Red Flags

Patient records that look just alike—from patient to patient or from visit to
visit.
◦ This can often occur when working with templates.
◦ Make sure that your billers and, thus , the insurance company can tell the reason for the visit
and what services were actually performed on the patient on a particular date.

Incomplete documentation: The office notes don't match the charges. Upcoding the E/M or the procedure (listing a procedure involving anesthesia or
sutures where anesthesia or sutures were not used). Perhaps a more involved
E/M was performed, but IF IT'S NOT DOCUMENTED IN THE NOTES, IT
DIDN'T HAPPEN.

ICD-9 (Dx) doesn't match the CPT (procedure).

Unbundling procedures to obtain a higher fee.
NCBPE 2012 New Licensee Orientation
Insurance Coding –
Red Flags cont’d

Failure to return overpayments. Most insurance companies now
recoup anyway which means they take the money away from the next
patient with the same insurance.; i.e., BCBS takes fee away from
Patient B to get a refund from you for patient A (whom you may have
seen 3 yrs. ago).

A high number of high level E/M codes (outside the Bell curve).

Duplicate billing of services.

Co-pay waivers/WIP' s.

Over-utilization of a service (every patient gets an x-ray or injection,
etc.
N.B. The Board receives numerous complaints throughout the year about
overcharges, duplicate billing, unbundling, charging for procedures patient didn’t
receive, over-utilization of services, etc.
NCBPE 2012 New Licensee Orientation
Notes of Exclusions from
Medicare Benefits (NEMB)
http://www.hipaaspace.com
/Medical_Forms/Centers_F
or_Medicare_Medicaid_Se
rvices/CMS_Forms/CMS_
Form_CMS20007English.p
df.aspx
NCBPE 2012 New Licensee Orientation
Notes of Exclusions from
Medicare Benefits (NEMB) cont’d
Form No. CMS-20007 (January 2003)
There are items and services for which Medicare will not pay

Medicare does not pay for all of your health care costs. Medicare only pays for
covered benefits. Some items and services are not Medicare benefits and
Medicare will not pay for them.

When you receive an item or service that is not a Medicare benefit, you are
responsible to pay for it, personally or through any other insurance that you
may have.

The purpose of this notice is to help you make an informed choice about whether
or not you want to receive these items or services, knowing that you will have to
pay for them yourself.

Before you make a decision, you should read this entire notice carefully.

Ask us to explain, if you don't understand why, Medicare won't pay.

Ask us how much these items or services will cost you (Estimated Cost: $
).
NCBPE 2012 New Licensee Orientation
Notes of Exclusions from
Medicare Benefits (NEMB) cont’d
Medicare will not pay for: _________________________________
Because it does not meet the definition of any Medicare benefit.
2. Because of the following exclusion * from Medicare benefits:
1.
◦Personal comfort items.
◦Routine physicals and most tests for screening.
◦Most shots (vaccinations).
◦Routine eye care, eyeglasses and examinations.
◦Hearing aids and hearing examinations.
◦Cosmetic surgery.
◦Most outpatient prescription drugs.
◦Dental care and dentures (in most cases).
◦Orthopedic shoes and foot supports (orthotics)
◦Routine foot care and flat foot care.
◦Health care received outside of the USA.
◦Services by immediate relatives.
◦Services required as a result of war.
◦Services under a physician's private contract.
NCBPE 2012 New Licensee Orientation
Notes of Exclusions from
Medicare Benefits (NEMB) cont’d
Services
Services
paid for by a governmental entity that is not Medicare.
for which the patient has no legal obligation to pay.
Home health services furnished under a plan of care, if the agency does not submit the
claim.
Items and services excluded under the Assisted Suicide Funding Restriction Act of 1997.
Items or services furnished in a competitive acquisition area by any entity that does not
have a contract with the Department of Health and Human Services (except in a case of
urgent need).
Physicians' services performed by a physician assistant, midwife, psychologist, or nurse
anesthetist, when furnished to an inpatient, unless they are furnished under arrangements
by the hospital.
Items and services furnished to an individual who is a resident of a skilled nursing facility (a
SNF) or of a part of a facility that includes a SNF, unless they are furnished under
arrangements by the SNF.
Services of an assistant at surgery without prior approval from the peer review organization.
Outpatient occupational and physical therapy services furnished incident to a physician's
services.
* This is only a general summary of exclusions from Medicare benefits. It is
not a legal document. The official Medicare program provisions are
contained in relevant laws, regulations, and rulings.
NCBPE 2012 New Licensee Orientation
Insurance Claim Forms
Generic Claim Form – HCFA 1500
http://www.ub-04software.com/hcfa-1500electronic-claim-form.php
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NCBPE 2012 New Licensee Orientation
Insurance Forms
Advance Beneficiary Notice (ABN)
http://www.advancebeneficiarynotice.net/do
wnloads/Form%20CMS-R-131.pdf
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NCBPE 2012 New Licensee Orientation
Questions? Concerns?
Linda H. Hatcher
Consultant
Triangle Medical Management
Mobile: (919) 632-8994
Office: (919) 850-9111
Fax: (919) 850-2499
[email protected]
NCBPE 2012 New Licensee Orientation