Billing Newsletter | May 2022

More documents

Recommendations

Info

I M P O R T A N T I N F O R M A T I O N Patients with balance Please allow to pay at the clinic. We should never turn patients that want to make a payment away. Questions about balance – <strong>Billing</strong> dpto. 972-957-3000 option 2. Payment by phone – Patient Payment Collectors: Nuvia Lucio ext. 8124 Patient Collections phone number – 1 800 711 6521 Medical Record Requests need to be sent to – Email: mdmedical@dmrs.net / Fax (213) 225-5070 / Phone (800) 359-8520 Patient refunds need an allowance period of 30 days to complete processing. Locums : Make sure progress note is signed and scanned, the correct template is used (acute / preventive), if correct template is needed, please ask RDO. Locum providers should never see Medicare patients. How to code new/established visits on the same day. (when the patient is truly a new patient to our facilities) PAYOR GROUP PATIENT AGE RULE CPTS YOU MAY USE COMMERCIAL ALL AGES Well visits are going to be billed as a new patient sick visits billed as if patient was established 99381 - 99387 99211 -99215 0 - 20 YEARS Well visits are going to be billed as a new patient 99381 - 99385 99201 - 99205 MEDICAID 21 YEARS AND MORE Well visits are going to be billed as a new patient Sick visits billed as if patient was established. 99385 - 99387 99211 - 99215 If visit is done by a Locum, two separate notes will need to be attached to the patients file
R E M I N D E R S PATIENTS' BENEFIT VERIFICATION Please be sure we are verifying: Benefits on all patients as well as collecting co-pays, deductibles and/or co-insurances at the time of the service. (please use Master Fee Schedule for collecting deductibles / coinsurances) Patient's benefits through TMHP and payor's portal every time a patient returns to clinic. That the provider is linked to Topcare Medical Group Inc. Benefits to know if Sports Physical is a covered benefit, for Superior Ambetter PAYOR SPECIFIC All Medicaid Insurance needs to be verified on the 1st of every month. If patient has a Dual Plan please make sure you use the presentation provided "Dual Policies" to verify insurance and load correct Medicaid and Medicare plans. If patient has CHC we must obtain authorization for CPT 17340 prior to performing. If the patient has BCBS HMO then they should not add BCBS PPO to the patients account but add BCBS HMO insurance record. PATIENTS' INFORMATION Please remember to update patient's information such as address and telephone number. Please update Medicare patient accounts with their new identification cards. Make sure that for children the demographics contains GUARANTOR/RESPONSIBLE PARTY. We are seeing numerous account where this is missing. If patient with insurance signs the "Self-Pay Form" please remove insurance from claim at the time of creation. PATIENT BALANCE If patient has an outstanding balance, please collect balances based upon our payment arrangements and/or call CBO to resolve with patient collections (ext. 8124) PCP INFORMATION LOGIN For all HMO’s, staff should update the PCP to our provider treating the patient at the time of service. Amerigroup has finished loading Amerivantage to our providers. You can call Amerigroup and they should be able to change PCP. EMPLOYEE FEE SCHEDULE If employee is coming for Office Visit, choose "Employee Fee Schedule" and adjust $0.01 under employee adjustment only. Do not adjust any other service done. Charges from "Employee Fee Schedule" are already adjusted and should be collected when performed. "Not every day is good, but there is something good in EVERY day".
Page 3: COVID-19 VACCINES GUIDELINES COVID

Billing Newsletter | May 2022

Create successful ePaper yourself

Delete template?

Save as template?