Billing Newsletter | June 2022

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.
"BIG journeys begin with
SMALL steps".