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RCM Revenue Cycle Management

Details: RCM - Revenue Cycle Management guide is the useful healthcare information of United States. This RCM guide is a free to use and contains useful information on Demo Entry, Medical Coding, Charge Entry, Claim Submission, Payment Posting and AR Follow Departments.

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Health Insurance in US (United States)

Details: Some health insurance plans also covers the prescription drugs. Insurance company is also known as insurer or health plan and it is an organization contracted with patient to pay for his health care expenses. Do you need health insurance in US (United States)?

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BCBS Prefix List

Details: Health insurance policy number: Policy number is a unique number, which is provided to their insured person by respective insurances in order for identification purposes and also for billing the healthcare claims. BCBS Prefix: BCBS prefix is a three character prefixes followed by the id number except for the following products and programs.

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BCBS Prefix List CAA to CZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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BCBS Prefix List UAA to UZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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BCBS Prefix List N2A to N9Z

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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Charge Entry in Medical Billing Process

Details: It relates not only whether a health care services of the procedure is covered but also to find whether the health care services is medically necessary. Billed amount: Billed Amount also called as charge amount. It is the amount charged for each service performed by the provider and entered at the time of charge entry.

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BCBS Prefix List H2A to H9Z

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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Offset in Medical Billing with Example

Details: Assume same Doctor-A rendered the health care services to the patient name John on 12/28/2019 and billed the claim to insurance company with billed amount of $150.00. Insurance company processed the claim and sets $80.00 to be paid for the provider on this claim for the health care services.

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BCBS Prefix List IAA to IZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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BCBS Prefix List XAA to XZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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Aetna address and Provider Phone Number

Details: Aetna Student Health Aetna Workers Comp Access Meritain Health: Refer Member Identification card: Aetna Signature Administrators: 800-238-6288: CoverMyMeds: 866-503-0857 (Preauthorization) 866-452-5017 (General Information) Aetna Medical and Behavioral health: 888-632-3862: Coventry (Including workers compensation and auto injury) 800-937-6824

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Denial Codes in Medical Billing

Details: Denial Code - 140 defined as "Patient/Insured health identification number and name do not match". Check eligibility to find out the correct ID# or name. Update the correct details and resubmit the Claim. 146: Denial Code - 146 described as "Diagnosis was invalid for the DOS reported". 1) Get the Claim denial date?

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BCBS Prefix List QAA to QZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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United Healthcare Phone Number

Details: Behavioral Health Department: 800-201-6991: Provider Services/Claim status: 800-666-1353 800-985-3293 (Chiropractic Services Optum health) Credentialing and Re Credentialing: 877-842-3210: Electronic Payments and statements: Helpdesk: 877-620-6194: Electronic Data Interchange(EDI) 800-842-1109: Eligibility and Benefits: 800-666-1353: Pharmacy

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Timely filing limit of Insurances

Details: Timely Filing Limit: Timely Filing Limit is the time frame set by insurance companies and provider has to submit health care claims to respective insurance company within the set time frame for reimbursement of the claims.

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Place of Service 02

Details: Telehealth: For enhancing the patient health condition, medical information is exchanged via electronic system from one place to another place and this is called as Teleheath or Telemedicine services. Getting reimbursed for telehealth services is little complicated, because the reimbursement guidelines for telehealth services vary based on the

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Healthfirst Customer Service-Health First Provider Phone

Details: Medicaid Managed Care and Child Health Plus: 866-463-6743: Personal Wellness Plan: 855-659-5971: Medicare Advantage Plans, Medicare Special Needs Plans, Healthfirst HMO B Small Group, and Healthfirst Healthy NY Small Group: 888-260-1010: Healthfirst AbsoluteCare FIDA Plan Participant Services: 855-675-7630: Senior Health Partners: 800-633-9717

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BCBS Prefix List U2A to U9Z

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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BCBS Prefix List YAA to YZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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BCBS Federal Phone Number for Providers and Members

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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CO 45 Denial Code

Details: It is the total amount charged from the provider to an insurance company for the health care services rendered to the patient. Provider Billed Amount = Insurance Allowed Amount + Write off. Fee Schedule: It is the lists of allowed amount document that gives the cost for each procedure code based on the patient insurance plan.

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BCBS Prefix List C2A to C9Z

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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Payment Posting in Medical Billing

Details: Health Saving Account-HSA:A bank account used to pay for health care expenses. Patient or patient employer can put tax free amount into their Health saving account and this can be used to pay for patient share of care costs like deductible or coinsurance. Claim in Process:Claim received and it’s still in process.

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Ambetter Phone number

Details: Ambetter NH Health Families Member and Provider Services Phone Number: 844-265-1278: Ambetter from PA Health & Wellness - Pennsylvania: 68069: 300 Corporate Center Drive, Suite 600, Camp Hill, PA 17011: Ambetter PA Health & Wellness Member and Provider Services Phone Number: 833-510-4727: Ambetter from Peach State Health Plan - Georgia: 68069

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RCM Revenue Cycle Management

Details: RCM - Revenue Cycle Management guide is the useful healthcare information of United States. This RCM guide is a free to use and contains useful information on Demo Entry, Medical Coding, Charge Entry, Claim Submission, Payment Posting and AR Follow Departments.

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What is Medical Billing and Medical Billing process steps

Details: What is Medical Billing? Medical Billing is a process of billing the healthcare claims to the respective insurances (also known as carriers) of the patient from the providers or medical billing companies in order for reimbursing the provider for the healthcare services delivered to the patient.

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Place of Service Codes – CMS POS Code 2021 List in Medical

Details: Place of Service Codes is also known as POS codes in Medical Billing and are maintained by CMS –Centers for Medicare and Medicaid Services). This Place of Service codes is a 2 digit numeric codes which is used on the HCFA 1500 claim form while billing the medical claims to the health care insurance companies, denoting the place where the healthcare services was performed …

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BCBS Prefix List GAA to GZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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BCBS Prefix List EAA to EZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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Ambetter Timely Filing Limit

Details: Ambetter from Buckeye Health Plan - Ohio: Initial Claims: 180 Days from the DOS (Participating Providers). 90 Days from the DOS (Non Participating providers). Reconsideration or Claim Disputes/Appeals: 180 Calender Days from the date of EOP or denial is issued (Participating provider).

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BCBS Prefix List TAA to TZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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Blue Cross Blue Shield Address

Details: Behavioral Health: Commercial Plans(HMO,PPO & NEHP) and Taft-Hartley: Anthem Blue Cross and Blue Shield PO Box 533 North Haven, CT 06473-0533 Behavioral Health: Commercial Plans(Federal Employee Program): PO Box 105557 Atlanta, GA 30348-5557 Medicare Advantage Plans(Anthem MediBlue/ Anthem MediBlue Dual Advantage): PO Box 1407 New York, NY 10008

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BCBS Prefix List V2A to V9Z

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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BCBS Provider Phone Number

Details: 866-510-8778 (Blue Shield Life and Health) Colorado: 888-817-3717 (Blue Card/National Accounts) 877-833-5742 (Local/Intra Plan) 866-438-9969 (Medicare Supplement) 888-346-0095 (Anthem MediBlue Plus/Dual Advantage) 800-852-5957 (FEP) 800-827-6422 (HMO-Health Maintenance Organization Colorado Guest Membership/Away from Homecare) Connecticut

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Place of Service 22

Details: Place of Service 22 in Medical billing: Place of Service 22 is also called as POS 22 in Medical Billing. Place of Service 22 is a two digit numeric code and used to identify the procedure performed in “On Campus – Outpatient Hospital”.

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BCBS Prefix List NAA to NZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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Pregnancy ICD 10 Code

Details: A high-risk pregnancy is a threat to the health and the life of the mother and the fetus. Code categories for coding edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (Code range- O10-O16)

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Medicaid Phone Number

Details: Public Health Services: 603-271-4501 Special Medical Services: 603-271-4488: New Jersey Medicaid Phone Number Department of Human Services, Division of Medical Assitance and Health Services-DHS: Apply for NJ Family care/ Select Medicaid Health Plan: 800-701-0710 Fraud and Abuse: 800-701-0710 Medicaid Health Benefits Identification Card Requests

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BCBS Prefix List WAA to WZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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Amerihealth Caritas Phone Number, Payer ID, TFL and Claim

Details: Prestige Health Choice Provider Phone Number: (800) 617-5727: 180 Days from the DOS (Participating Providers) 12 Months from the DOS (Non Participating Providers) Select Health of South Carolina - First Choice Provider Phone Number, Claims address, Payer ID and Timely filing Limit: 23285: PO Box 7120 London, KY 40742

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BCBS Prefix List DAA to DZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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BCBS Prefix List AAA to AZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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BCBS Prefix List JAA to JZZ

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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Kaiser Permanente Phone Number

Details: Health Insurance in United States of America (1) Healthfirst Directory (1) ICD 10 Codes Guide – Healthcare (19) Kaiser Permanente Directory – Healthcare (1) Medicaid Directory – Healthcare (1) Medical Billing Cycle – Healthcare (7) Medical Terminology List – Healthcare (1) Modifiers Guide – Healthcare (11) Molina Directory

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Workers Compensation

Details: Found stress related or mental Health conditions which are not from your job. Horseplay or fighting. How much is workers compensation Insurance cost? Workers compensation insurances varies state by state and depend on number of different factors to come up with your premium costs such as: Payroll; Types of job workers do (Classification codes)

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CO 26 CO 27 and CO 28 Denial Codes

Details: Payer will deny the health care claims with CO 28 Denial Code – Coverage not in effect at the time the service was provided, when the health coverage was not in effect at the time of health care services was rendered to patient. What steps needs to be taken, when you get the denial code CO 26, CO 27 and CO 28 in medical billing:

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CO 197 Denial Code

Details: Physician has to obtain permission for certain health care services from the insurance company before rendering those services to patient, in order to get the claim reimbursed. Retro authorization: Physician can obtain permission for health care services from the insurance company after the services rendered to patient in order for claims get paid.

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