Private Practice Insurance Credentialing and Billing. Danielle Kepler, LCPC.
|
|
|
- Karen Park
- 5 years ago
- Views:
Transcription
1 Private Practice Insurance Credentialing and Billing Danielle Kepler, LCPC
2 Accepting Insurance in Your Private Practice Prepare for Credentialing Tax ID/NPI/Office Location CAQH Paneling/Applying Billing Verifying insurance Filing Claims
3 Prepare for Credentialing Secure an office location Much easier to apply to panels with your service location in place than having to change it later Tax ID/EIN Decide on your tax structure (Sole Prop, LLC, S-Corp) and obtain an EIN. Keep the IRS letter you receive and make note of the address you used to set-up your EIN NPI (Type 1 and Type 2) Type 1=individual/rendering all need this Type 2=Organizational/Billing/Group needed if you have a group contract
4 Prepare for Credentialing CAQH (called CAQH ProView Database of all of your professional information that insurance companies use for credentialing purposes Scan the following documents (in PDF format) for your CAQH profile Professional license Resume/CV Proof of Malpractice Insurance Facesheet State and CAQH Attestation Releases (found in CAQH)
5 Apply to Panels Ask local clinicians which plans reimburse well in the area Ask your friends/family which plans they have from their employer Look on a therapist directory to see which plans clinicians take in your area Google the panel name and provider or join network to start the application process
6 Credentialing Tips Keep a record of: When you sent in your application to each panel Important phone numbers/contacts of each panel (provider relations etc.) Follow-up within 2-3 months if you have not heard anything READ your contracts once you receive them Ask for your fee schedules and make sure you are satisfied with the reimbursement (some are non-negotiable) Keep checking the provider directory listings for your information (sometimes you find out you are paneled this way)
7 While waiting. How Will You Bill? Electronic Health Record (EHR) Some require you to sign up for a clearinghouse Clearinghouse Office Ally or Availity are the major FREE ones Insurance Company s Portal Update your paperwork to reflect you accept insurance (HIPAA form for insurance billing etc.) Once you receive your welcome letter update your marketing to reflect that you now accept ABC insurance
8 Info Needed From Client Client calls and wants to use their ABC insurance Info you will need from the client: Demographics: Name (first and last), date of birth, address Primary insured s demographics if the client is not the primary Insurance Company Info: Name of plan, Member ID, Group Number Customer Service Number (on back of card just in case!)
9 Verify MH Insurance Benefits Can use Availity (BCBS, Humana, Aetna, Cigna) Insurance portals (Navinet etc.) Call the insurance company See handout for questions to ask/answer when verifying benefits
10 Lingo to Know (See Handout) Co-pay A set fee amount client owes at time of service. Co-insurance Client and insurance company share cost of service. Usually marked as a %. If your contracted rate was $100 and the co-insurance was 20%, the client would pay $20 and the insurance company would pay $80. Deductible Amount required to be paid by client in full until insurance will start paying. What they pay/what gets applied is based on your contracted rate or UCR (if OON). Out of Pocket Max/Limit Maximum amount client will pay out of pocket towards their medical expenses. Once met, the insurance covers all expenses (co-pay etc.)
11 CMS-1500 Claim Form This is why we file claims electronically!
12 Info Needed for Claim Provider Info EIN Rendering NPI (NPI 1-provider who performed the session) Service Address aka Office Address Billing Address (the one on your W-9) If you have a group EIN then you also have a Type 2 NPI
13 Info Needed for Claim Session Info Needed Diagnosis (ICD-10) Date of Session Location (11 for office) CPT Code of Session (see handout) Unit Number (1) Full Fee of Session for Charge
14 Additional Resources Insurance Credentialing and Billing Consulting Insurance Answers Podcast Available on itunes and Stitcher Show Notes/Handouts available on our Facebook Page
Goals. Reflection. The 3 Ps: Marcus Lemonis. Private Practice Management: From Intake to Billing 9/18/16
Private Practice Management: From Intake to Billing Christian J. Dean, Ph.D., LPC-S, LMFT, NCC And Sola Kippers, Ph.D., LPC-S, LMFT Goals O Have an understanding of overall practice components (brief overview)
HIPAA 5010 Webinar Questions and Answer Session
HIPAA 5010 Webinar Questions and Answer Session Q: After Jan 2012, do the providers who bill on paper have to worry about 5010? Q: What if a provider submits all claims via paper? Do the new 5010 guidelines
HNS CMS Claim Checklist
HNS CMS 1500 - Claim Checklist Prior to submitting paper claims, please carefully check your completed claim form against this checklist. Please contact your HNS Service Representative if you have any
Credentialing 7/11/2018. Peter J. Cass, OD - Disclosures. Credentialing. Credentialing Purpose
Peter J. Cass, OD Peter J. Cass, OD - Disclosures Owner, Beaumont Family Eye Care (VS) Beaumont Texas Vice President, Practice Compliance Solutions Immediate President, Texas Optometric Association Chair
Getting Started with Insurance Billing for CHIP
Getting Started with Insurance Billing for CHIP The following guide is for U.S. physicians and dietitians seeking to bill Medicare and insurance providers for their running of Complete Health Improvement
CMS 1500 Claim Filing Instructions. 1 Not Required Type of health insurance coverage applicable to claim. Patient s type of coverage.
Field Locator Requirements CMS 1500 Claim Filing Instructions Field Description 1 Not Required Type of health insurance coverage to claim Patient s type of coverage. 1a Required Insured s ID Number Identification
Provider/Payer Enrollment Tips and Tricks
Provider/Payer Enrollment Tips and Tricks Thea Hensley Provider Enrollment Coordinator Cody Regional Health 307-578-2498 ahensley@codyregionalhealth.org Vocabulary Provider/Payer Enrollment-Refers to the
Medical Nutrition Therapy Reimbursement
Medical Nutrition Therapy Reimbursement W H A T A R E T H E ISSUES? H O W WILL I NAVIGATE T H E M? HOW LONG W I L L IT TAKE? W H E R E CAN I FIND GUIDANCE? Kristin Hatch, RD,LDN,CDE N u t r i t i o n f
Nuts and Bolts of Getting Paid for the Utah RDN. Nikki Kendrick, MDA, RDN, CNSC UAND Reimbursement Representative
Nuts and Bolts of Getting Paid for the Utah RDN Nikki Kendrick, MDA, RDN, CNSC UAND Reimbursement Representative Objectives Participants will be able to locate the best and most current resources from
Overcoming to Become a Provider 3 REIMBURSEMENT RELUCTANCE
1 Learning Objectives Assess if accepting reimbursement is appropriate for business. Establish Tax ID, NPI number, and CAQH log-in to start credentialing process. Outline process for benefits verification
Frequently Asked Questions AllWays Health Partners
Frequently Asked Questions AllWays Health Partners Effective January 1, 2019, Optum began managing the Behavioral Health and Substance Use benefits for AllWays Health Partners, formerly known as Neighborhood
The Realities of Billing Insurance in the Private Practice Setting
The Realities of Billing Insurance in the Private Practice Setting The Good, The Bad, and The Ugly By Ginger Bailey, RDN, CD Conflict of Interest No conflict of interest are known Objectives Give RDs more
Electronic Claims Submission (EDI) Training
Electronic Claims Submission (EDI) Training Part 1 How to complete the CMS-1500 form Contact Information: EDI@I-AHC.net 866-374-9558 770-455-0040 1 Two parts of Training Part 1: How to complete CMS-1500
Proprietary information of MedCost LLC. Do not distribute or reproduce without express permission of MedCost.
Provider Manual MedCost Network Updated January 26, 2018 Provider Manual January 26, 2018 Version Page 2 Table of Contents Introduction Contracting How to Use This Manual About MedCost When and How to
What You Need to Know When Billing With FMBS
What You Need to Know When Billing With FMBS Power Point Purpose To educate and inform the providers associated with Favored Medical Billing on key billing and collection points FMBS Billed Charges national
Applied Behavior Analysis (ABA) Proper Billing Guidelines & Authorization Updates. January 2016
Applied Behavior Analysis (ABA) Proper Billing Guidelines & Authorization Updates January 2016 The Way Forward 2 Objectives Overview of Claims-Proper Billing Procedures NPI Registration Authorization Updates
New Provider Forms. If you have any questions, please us.
New Provider Forms Thanks for your interest in becoming a HAP provider. Following this page are three forms we ll need you to complete and return back to us at Providers_Recruitment@hap.org: Physician
Please submit claims and encounters electronically via Office Ally at
Claim Submission All claims must be submitted within 90 calendar days from the date of service for contracted providers unless otherwise stated in the provider service agreement. Please submit claims and
During This Phase, We Recommend You Take These Steps:
The Basics of Billing and 1 The Basics of Billing and Introduction 2 Phase 1 Welcome to Cleveland l Clinic List Phase 1 Billing Facts: 1. My Policy ID number is. 2. My Group ID number is. 3. My insurance
Claim Form Billing Instructions CMS-1500 (08-05) Claim Form
Claim Form Billing Instructions CMS-1500 (08-05) Claim Form Presbyterian Health Plan / Presbyterian Insurance Company, Inc Original: 06/24/07 Page 1 of 10 Presbyterian Health Plan / Presbyterian Insurance
PROVIDER MANUAL. Revised January Page 1
PROVIDER MANUAL Revised January 2018 Page 1 Table of Contents Introduction 3 General Information 4 Who Do I Call? 5 ID Card Logos 6 Credentialing/Recredentialing 7 Provider Changes 8 Referral and Authorization
The PT Patient s Guide to Understanding Insurance
The PT Patient s Guide to Understanding Insurance Insurance 101 for PT Patients So, your insurance covers physical therapy which means you won t have to pay anything out-of-pocket for your therapy visits,
Billing for Immunizations. Jeannine Carney Insurance Billing Manager Albany County Department of Health
Billing for Immunizations Jeannine Carney Insurance Billing Manager Albany County Department of Health JCarney@AlbanyCounty.com Objectives Determine Population served Develop a Billing Strategy Educate
RECONTRACTING 10/31/2016. Aetna Medicare Advantage. Aetna Behavioral Health
DOING BUSINESS WITH AETNA & COFINIT Y 1 2 RECONTRACTING -Separate agreements. -Separate networks. - Aetna is a Payer, Cofinity is a Network Access Agreement. Aetna Medicare Advantage Employer Based Plan.
Vermont Collaborative Care, LLC. Release date: May 15, 2013 Updates to original March 2013 Overview highlighted in yellow
Vermont Collaborative Care, LLC Release date: May 15, 2013 Updates to original March 2013 view highlighted in yellow Vermont Collaborative Care, LLC (VCC) will begin operations on July 1, 2013. VCC was
Housekeeping. Link Participant ID with Audio. Mute your line UNMUTED. Raise your hand with questions
Housekeeping Link Participant ID with Audio If your Participant ID has not been entered, dial #ParticipantID#. EXAMPLE: Participant ID is 16, then enter #16#. Mute your line UNMUTED MUTED OTHER MUTE OPTIONS
Rev 7/20/2015. ClaimsConnect Rejection Guide
ClaimsConnect Rejection Guide Helper Client, The purpose of this document is to assist you in accelerating the resolution of claim rejections. We have identified the most frequent rejection messages, and
DENTAL NEWSLETTER Third Quarter 2018
Third Quarter 2018 Appointment availability requirements for Maryland. Effective immediately, all PPO Providers in Maryland are required to follow these appointment availability standards: Urgent appointment
Provider Orientation. style. Click to edit Master subtitle style. December, 2017
Click EMHS to Employee edit Master Health title Plan Provider Orientation Click to edit Master subtitle December, 2017 Pam Hageny Director of Health Plan Operations & Provider Network Beacon Health EMHS
Management: A Guide To Optimizing. Market
Best Practices In Revenue Cycle Management: A Guide To Optimizing Your Revenue Cycle In A Value-Based Market T h e 2 0 1 8 O P E N M I N D S M a n a g e m e n t B e s t P r a c t i c e s I n s t i t u
Pacific Symposium 2017
Treating Veteran Population and Getting Paid for Claims Part I and II Jennifer M. Williams, PhD, L.Ac Jennifer@woodelement.com Pacific Symposium 2017 1 Disclosure This certifies that I, Jennifer M. Williams,
WINASAP: A step-by-step walkthrough. Updated: 2/21/18
WINASAP: A step-by-step walkthrough Updated: 2/21/18 Welcome to WINASAP! WINASAP allows a submitter the ability to submit claims to Wyoming Medicaid via an electronic method, either through direct connection
LEARNING WHAT IT TAKES TO BILL MANAGED CARE INSURANCES
home health LEARNING WHAT IT TAKES TO BILL MANAGED CARE INSURANCES Lynn Labarta, CEO, Imark Billing 1 home health LYNN LABARTA CEO, Imark Billing Founder of Imark Billing with over 15 years experience
WELCOME. Medical Benefits Abroad. Offered by: Cigna Health and Life Insurance Company or its affiliates /15
WELCOME Medical Benefits Abroad Offered by: Cigna Health and Life Insurance Company or its affiliates. 887136 09/15 Everything you need to rest easy when you travel internationally on company business.
Avoiding Denials Related to Credentialing and Product Participation
Avoiding Denials Related to Credentialing and Product Participation Sponsored by TriZetto Provider Solutions Penny Noyes President, CEO & Founder Objectives for this session How to research and verify
Indiana Health Coverage Program Behavioral Health Presented by CompCare October 22-24, 2007
Indiana Health Coverage Program Behavioral Health Presented by CompCare October 22-24, 2007 Topic Behavioral Health About MDwise About CompCare CompCare Provider Contracting Process CompCare Quick Contact
CPT is a registered trademark of the American Medical Association.
Welcome to s Webinar and Audio Conference Training. We hope that the information contained herein will give you valuable tips that you can use to improve your skills and performance on the job. Each year,
APPLICATION FOR INITIAL CREDENTIALING for ADVANCED PRACTICE PROVIDERS and ALLIED HEALTH PROFESSIONALS
APPLICATION FOR INITIAL CREDENTIALING for ADVANCED PRACTICE PROVIDERS and ALLIED HEALTH PROFESSIONALS OhioHealth Group Clinically Integrated Network (CIN) (previously Health 4 / The Medical Group of Ohio)
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions October 2016 AAHAM Updates
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions October 2016 AAHAM Updates Debby Synowicki Sr. Provider Relations Representative Aetna s Values Wheel 2 Aetna
NPI# PHYSICAL THERAPY MANAGED CARE BENEFITS/PRIOR AUTHORIZATION. Outpatient Physical Therapy Centers
NPI#1780614453 Scheduling and Billing 1 800 783 1008 www.theptgroup.com PHYSICAL THERAPY MANAGED CARE BENEFITS/PRIOR AUTHORIZATION Outpatient Physical Therapy Centers Apollo, Derry, Greensburg Pellis Rd.,Greensburg
The Physical Therapy Patient s Guide to Understanding Insurance
The Physical Therapy Patient s Guide to Understanding Insurance Insurance 101 for PT Patients So, your insurance covers physical therapy which means you won t have to pay anything out-of-pocket for your
WELCOME. Medical Benefits Abroad. Offered by: Cigna Health and Life Insurance Company or its affiliates a 10/18
WELCOME Medical Benefits Abroad Offered by: Cigna Health and Life Insurance Company or its affiliates. 887136 a 10/18 Everything you need to rest easy when you travel internationally on company business.
Magellan Claims Settlement Practices and Dispute Resolution Notice to Providers Contracted with California Subsidiaries of Magellan Health, Inc.
Magellan Claims Settlement Practices and Dispute Resolution Notice to Providers Contracted with California Subsidiaries of Magellan Health, Inc.* Revised effective Nov. 15, 2016 *Human Affairs International
PCG and Birth to Three Billing Guidance
This information summarizes PCG s and Programs role in accepting data, billing and moving claims towards full adjudication. 1 Workable Claims: Commercial Claims: For Dates of Service from July 1, 2017
Health Plan Identifier ( HPID ) Requirements. By Larry Grudzien Attorney at Law
Health Plan Identifier ( HPID ) Requirements By Larry Grudzien Attorney at Law 1 Agenda Introduction HIPAA Standard Transactions Rules Health Plan Identifier (HPID) Certification of Compliance with Standard
Glossary of Terms. Account Number/Client Code. Adjudication ANSI. Assignment of Benefits
Account Number/Client Code Adjudication ANSI Assignment of Benefits This is the number you will see in the welcome letter you receive upon enrolling with Infinedi. You will also see this number on your
Medicare Advantage 11/02/17 NOT FINAL HANDOUT
FINAL HANDOUT will be provided on 11/2 by Mary Petersen extra attachments are not included in this handout Medicare Advantage: tools and strategies to collecting 5343 North 118 th Court Milwaukee WI 53225
Completing the CMS-1500 Claim Form
Completing the CMS-1500 Claim Form Below are instructions for filling out a CMS-1500 Claim Form (version 08/05) when submitting a claim to CareFlorida. Each field on the form is described, and all required
Consumer Price Transparency Examples State and National Websites
Consumer Price Transparency Examples State and National Websites State Consumer Health Information and Policy Advisory Council Meeting March 24, 2016 Health Transparency Websites What do consumers want
Behavioral Health Professional Refresher Workshop. Presented by The Department of Social Services & HP
Behavioral Health Professional Refresher Workshop Presented by The Department of Social Services & HP 1 Training Topics Client Eligibility Verification Policy Review Fee Schedule Updates Provider Bulletins
Form DFS-F5-DWC-9 B. Completion Instructions
Completion Instructions Submitted by Ambulatory Surgical Centers A. Header Information Health Care Providers shall enter Insurer/Carrier name, address and zip code in the blank area on top-right side of
Managed Care Lessons Learned THE PROVIDER'S PERSPECTIVE
Managed Care Lessons Learned THE PROVIDER'S PERSPECTIVE June 7, 2016 Presenters Meg Baier, TAC Project Manager, ICL/MCTAC Chris Copeland, Chief Operating Office, ICL Noah Isaacs, Managed Care Project Manager,
CHOC Health Alliance Downstream Provider Notice CLAIMS SETTLEMENT PRACTICES & DISPUTE RESOLUTION MECHANISM
CHOC Health Alliance Downstream Provider Notice CLAIMS SETTLEMENT PRACTICES & DISPUTE RESOLUTION MECHANISM As required by Assembly Bill 1455, the California Department of Managed Health Care has set forth
Claims Submission Process Overview. For Consumer-Directed Attendant Care and Waiver Care Providers
Claims Submission Process Overview For Consumer-Directed Attendant Care and Waiver Care Providers Agenda Member Liability Claims Submission CMS-1500 Form Claims Reconsideration Member Liability for Payment
Cenpatico South Carolina Frequently Asked Questions (FAQ)
Cenpatico South Carolina Frequently Asked Questions (FAQ) GENERAL Who is Cenpatico? Cenpatico, a division of Centene Corporation, is one of the nation s most experienced behavioral health companies providing
Intensive Case Management Primary Care Provider Training
Intensive Case Management Primary Care Provider Training NaviNet Enhancements Kelley Royer-Marek Manager, Risk Adjustment Programs kroyer-marek@amerihealthcaritas.com December, 2017 What is the purpose
Claims Submission and Prior Authorization Process Overview
Claims Submission and Prior Authorization Process Overview Agenda: Claims and Billing Prior Authorization PCA-1-000560-01072016_01122016 Claims and Billing PCA-1-000560-01072016_01122016 Member Copayments
Claims INFO Adjustment Submission Guide
Claims INFO Adjustment Submission Guide Revised March 2013 Overview Claims adjustments can be performed only on claims in a Paid or Denied status and are allowable during a period of up to 18 months following
AETNA DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION PAYER ID NUMBERS SPECIAL NOTES
1304 Vermillion Street Hastings, MN 55033 Ph 800-482-3518 Fax 651-389-9152 www.edsedi.com AETNA DENTAL ELECTRONIC REMITTANCE ADVICE (ERA) ENROLLMENT REGISTRATION PAYER ID NUMBERS 60054 SPECIAL NOTES Electronic
The information presented in this Webinar is current as of date of live airing July 16, Emily Putnam Senior Manager, Sales
The information presented in this Webinar is current as of date of live airing July 16, 2014 Emily Putnam Senior Manager, Sales Evaluate your current self-pay strategy Explore how practice management can
Claim Form Billing Instructions CMS 1500 Claim Form
Claim Form Billing Instructions CMS 1500 Claim Form Item Required Field? Description and Instructions. 1 Optional Indicate the type of health insurance for which the claim is being submitted. 1a Required
INTERMEDIATE ADMINISTRATIVE SIMPLIFICATION CENTERS FOR MEDICARE & MEDICAID SERVICES. Online Guide to: ADMINISTRATIVE SIMPLIFICATION
02 INTERMEDIATE» Online Guide to: CENTERS FOR MEDICARE & MEDICAID SERVICES Last Updated: February 2014 TABLE OF CONTENTS INTRODUCTION: ABOUT THIS GUIDE... i About Administrative Simplification... 2 Why
2019 Merit-based Incentive Payment System (MIPS) Quality Performance Category: Medicare Part B Claims Data Submission Fact Sheet
2019 Merit-based Incentive Payment System (MIPS) Quality Performance Category: Medicare Part B Claims Data Submission Fact Sheet The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the
Clinician Tax ID Add/Update Form
Clinician Tax ID Add / Update Form (Individually Contracted Clinician use Only) PLEASE FOLLOW THE DIRECTIONS BELOW: Prior to filling out this form, review the information in your Provider Record on providerexpress.com
FREQUENTLY ASKED QUESTIONS (DESIGNED FOR GOOSE CREEK CONSOLIDATED INDEPENDENT SCHOOL DISTRICT)
FREQUENTLY ASKED QUESTIONS (DESIGNED FOR GOOSE CREEK CONSOLIDATED INDEPENDENT SCHOOL DISTRICT) What is NexStep? NexStep is underwritten by Fidelity Security Life Insurance Company (Kansas City, Missouri)
FREQUENTLY ASKED QUESTIONS
FREQUENTLY ASKED QUESTIONS What is the Major Medical Complement? The Major Medical Complement is an insured product designed to help pay deductibles, coinsurance and co-payment amounts for those with high
Holistic Speech & Language Phone: (206) Fax: (206)
Client Intake Form Demographic Information Last Name: First Name: of Birth: Sex: Diagnosis (if known): Parent/Guardian Name(s): Home Address: Parent #1 Phone: Parent #2 Phone: Parent #1 Email: Parent #2
The Acupuncturist s Guide to Insurance Credentialing. Jamie Smith & Valondra Nimrod
The Acupuncturist s Guide to Insurance Credentialing Jamie Smith & Valondra Nimrod QIP Needs analysis Topic- Credential process for new acupuncturist Target audience- Recently Licensed Acupuncturist Needs
Provider/CA Network Training
Provider/CA Network Training November 2017 1926 Northlake Pkwy, Suite 100 ٠ Tucker, GA 30084 ٠ 770-455-0040 ٠ 866-374-9558 ٠ www.i-ahc.net Training Outline Reading ID Cards Benefit Verification Completing
Secure Provider Web Portal Overview 0917.MA.P.PP
Secure Provider Web Portal Overview 0917.MA.P.PP Agenda Secure Web Portal Administration Quality Reports Eligibility Member Record Patient List Authorizations Claims Review Claims Secure Messaging Administration
CLINICAL RESOURCE GROUP, INC. CHIROPRACTIC ADMINISTRATIVE MANUAL
CLINICAL RESOURCE GROUP, INC. CHIROPRACTIC ADMINISTRATIVE MANUAL UPDATED: 1-1-2012 TABLE OF CONTENTS Chapter One - Provider Services Contact Information Benefit and Summary Verification Communication Resources
Provider Manual Blue Cross and Blue Shield of Vermont and The Vermont Health Plan
Provider Manual 2018 Blue Cross and Blue Shield of Vermont and The Vermont Health Plan Table of Contents Provider Manual 2017 Blue Cross and Blue Shield of Vermont and The Vermont Health Plan Section 1
The following questions were received in response to our provider webinars presented by Blue Shield of California s network management teams.
Ancillary Claims Filing Requirements Frequently Asked Questions The following questions were received in response to our provider webinars presented by Blue Shield of California s network management teams.
TODAY S PRESENTERS AND CONTACT INFORMATION
DECEMBER 9, 2011 TODAY S PRESENTERS AND CONTACT INFORMATION Connie Winkley, Education Coordinator, Institutional Provider Relations, Blue Cross and Blue Shield of Kansas Connie.winkley@bcbsks.com, 785-291-7236
Fundamentals of Chiropractic Billing
Fundamentals of Chiropractic Billing A complete guide to everything you need to know to submit your Chiropractic claims and get reimbursed properly for your services Jacque Keil, CEO KMK Consultants, LLC
Chapter 7. Billing and Claims Processing
Chapter 7. Billing and Claims Processing 7.1 Electronic Claims Submission 3 7.1.1 How it Works... 3 7.1.2 Advantages... 3 7.1.3 How to Initiate... 4 7.1.4 Transactions Available... 5 7.1.5 NAIC Codes...
BHSDSTAR. Claims Billing Guide. Updated 7/18/17. Claims Billing Guide Version 1.2. Falling Colors: Claims Billing Guide Page 1 of 10
Updated 7/18/17 Falling Colors: Page 1 of 10 Table of Contents 1. Introduction... 3 2. Submitting Claims... 3 3. Client Eligibility and Registration... 3 4. Billing Rules... 4 4.1 No Shows... 4 4.2 Required
MCR, LLC. Plan Year:... January 1, 2018 to December 31, FSA Health Care Maximum Election:... $2, [pre-funded election]
![MCR, LLC. Plan Year:... January 1, 2018 to December 31, FSA Health Care Maximum Election:... $2, [pre-funded election]](/thumbs/86/93858772.jpg "MCR, LLC. Plan Year:... January 1, 2018 to December 31, FSA Health Care Maximum Election:... $2, [pre-funded election]")
Flexible Spending Accounts MCR, LLC The FSA plans are provided to allow employees the ability to set aside pre-tax dollars to pay for out-ofpocket expenses incurred by both the employee and their eligible
Introduction to HIPAA for Psychotherapists. Introduction
Introduction to HIPAA for Psychotherapists Introduction The Health Insurance Portability and Accountability Act (HIPAA) can be confusing and scary to psychotherapists. But it is very relevant to Digital
Revenue Cycle Management: Understanding and Implementing Best Practices for Efficient and Accurate Reimbursement
Revenue Cycle Management: Understanding and Implementing Best Practices for Efficient and Accurate Reimbursement Presented by Scott Spradling Objectives Understand Contracting/Credentialing Process & Payor
Sponsored by: Approved instructor
Sponsored by: Approved About the Speaker Nancy M Enos, FACMPE, CPMA CPC-I, CEMC is an independent consultant with the MGMA Health Care Consulting Group. Mrs. Enos has 40 years of experience in the practice
Provider Orientation. Behavioral Health. Molina Healthcare of Wisconsin
Provider Orientation Behavioral Health Molina Healthcare of Wisconsin Molina Healthcare was established in 1980 by the late Dr. C. David Molina to provide healthcare services to low income patients. Who
Step 3: To assist us in determining the available list of pharmacy plans to be contracted, please complete the enclosed Insurance Payer List.
BillingScripts Rx Initial Enrollment Packet Thank you for choosing BillingScripts Rx for your pharmaceutical billing and funding services. This Initial Enrollment Packet contains instructions and forms
User Guide 2015 Physician Quality Reporting System (PQRS) Payment Adjustment Feedback Report
User Guide 2015 Physician Quality Reporting System (PQRS) Payment Adjustment Feedback Report Page 1 of 16 Disclaimer This information was current at the time it was published or uploaded onto the web.
How to Form an LLC in Florida
How to Form an LLC in Florida llcuniversity.com/florida-llc Matt Horwitz Florida LLC Costs: Florida LLC filing fee: $125 (one-time) Florida LLC annual report fee: $138.75 (per year) Need to save time?
Administrative Guide
Physician, Health Care Professional, Facility and Ancillary Provider Administrative Guide 2012 KanCare Program DRAFT PENDING ADDITIONAL UPDATES AND STATE OF KANSAS APPROVAL DRAFT PENDING ADDITIONAL UPDATES
DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS COMPENSATION
DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS COMPENSATION FORM DFS-F5-DWC-9-B. 1. TYPE OF CLAIM T 1a. INSURED S ID NUMBER Enter the Social Security Number or the Division-Assigned Number of the
DME Providers ACA Requirements for Ordering Providers
DME Providers ACA Requirements for Ordering Providers On February 28, 2017 an RA message was published to address the ACA requirement that DME (Durable Medical Equipment) providers include the ordering
Getting started with and using electronic remittance advice (ERA) and electronic funds transfer (EFT)
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Getting started with and using electronic remittance advice (ERA) and electronic funds transfer (EFT) www.aetna.com
Claims Claim Submission QUICK REFERENCE
Claims Claim Submission QUICK REFERENCE This will review the process of how to submit a claim online and check the status of a previously submitted claim. Get Started 1. From, click Link and sign in NOTE:
Network Health Claims Editing Portal
Network Health Claims Editing Portal CPT codes, descriptions and other CPT material only are copyright 2010 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative
Welcome to Aetna International How to get the most from your benefits I (5/17) aetnainternational.com
Welcome to Aetna International How to get the most from your benefits 46.02.330.1 I (5/17) aetnainternational.com It s time to put your benefits to work. We re here to help make it easy. What to do right
Welcome. The Best Care. Because We Care. -1-
Welcome Second Quarter 2007 EDS Workshop Presented by Corporate MDwise Sherri Miles Provider Relations Manager Jacquie Marsalis-Provider Relations Manger/CompCare The Best Care. Because We Care. -1- About
Understanding the Incorporation process
Understanding the Incorporation process Q: Can a Foreign Nationality Entrepreneur who is not a US Citizen or a Non US Resident be a shareholder of a US Corporation? A: Yes. U.S. laws allow a foreign nationality
You must write DME at the top center of the claim form!
CMS 1500 (02/12) INSTRUCTIONS FOR DME SERVICES You must write DME at the top center of the claim form! Field/Item # Description Instructions Alerts 1 Medicare / Medicaid / Tricare / ChampVA / Group Health
Electronic Claims Guide
Electronic Claims Guide Arizona Computer Services, Inc th ARIZONA COMPUTER SERVICES, INC. 5727 N 7 Street Suite 640 Phoenix, Arizona 85014 (602) 263-8958 www.acsmb.com Table of Contents Table of Contents...
Southern Kennebec Child Development Corp Health Reimbursement Arrangement Benefit Overview
Southern Kennebec Child Development Corp Health Reimbursement Arrangement Benefit Overview Your employer is providing you with tax-free reimbursement for certain qualified medical expenses through an HRA
Professional claims may be submitted to Eastpointe via 837P or the AlphaMCS Provider Portal.
The CMS1500 form is a form that is used to bill professional claims (non-institutional) for services types such as Outpatient Therapy, Evaluation & Management, Innovations and Enhanced. The instructions
Innovation Health At-A-Glance
Innovation Health At-A-Glance A quick reference guide for health care professionals 71.02.801.1 A (3/15) innovation-health.com A guide for doing business with Innovation Health Getting started with Innovation
DoD NAF HBP. Benefits Overview for Retirees Effective January 1, November 6 December 1 click on retirees blue tab
DoD NAF HBP Benefits Overview for Retirees Effective January 1, 2018 November 6 December 1 www.nafhealthplans.com click on retirees blue tab Conference Call #: 844-712-3250 passcode: 94500945 Good News