by Medical Billing | May 11, 2016 | Medicare payment basics
Appeal status lookup – Part B help guide The appeals status lookup tool enables providers to check the status on active redeterminations to confirm if the appeal has been received by First Coast Service Options. When using the appeals status lookup, all fields are...
by Medical Billing | May 1, 2016 | Medicare payment basics
When to file an appeal Once an initial claim determination is made, providers, participating physicians, and other suppliers have the right to appeal. Physicians and other suppliers who do not take assignment on claims have limited appeal rights. Medicare offers five...
by Medical Billing | Apr 26, 2016 | Medicare payment basics
Q: What are some common situations when I can or cannot adjust or reopen claims? A: Providers are responsible in determining when it is appropriate to make corrections to paid (status/location P/B9997) or rejected (status/location R/B9997) claims. Listed below are...
by Medical Billing | Apr 18, 2016 | Medicare payment basics
Q: What is the difference between a claim reopening and an adjustment? A: Reopening’s are different from adjustment bills based on the following rules: • Adjustment bills are subject to normal claims processing timely filing requirements (that is, filed within one...
by Medical Billing | Oct 22, 2015 | Medicare payment basics
2016 PQRS Payment Adjustment and Informal Review Process On September 11, CMS began distributing letters to Physician Quality Reporting System (PQRS) individual Eligible Professionals (EPs), EPs providing services at Critical Access Hospitals billing under method II,...
