CMS 1500 is the form used to submit claims.
Deductibles are often $100 for physician services and outpatients.
Allowable amount will vary according to the plan, but we usually see the allowable amount 80%.
A surgical financial disclosure form is required for all […]
Tricare differs from other insurance companies. Tricare is a health care program for:
Eligible survivors of members of the uniformed services. Active duty members of the military and qualified family members. Champus eligible retirees and qualified family members.
Tricare consists of three main plans:
Tricare’s fiscal year for collecting deductible runs […]
Aetna is one of the most important insurance carriers in the United States and generally, billing an insurance company is different from one to another. In this post I got some of the medical office codes that Aetna covers for PCP (Prime Care Physician.)
Hi coders, today we have frequently repeated medical billing terms that we read in insurance policies, EOBs and sometimes face sheets. It is important to know well these terms to do your billing correctly and accurately.
Under the jurisdiction of the Department of Health and […]
Place of service is the medical facility where the medical service is rendered by the health care physician.
What is the pre-existing condition?
Pre-existing condition is any personal illness or disability that the patient has before signing a contract with a health care insurance. This pre-existing condition is not covered by insurance for a certain period. After this period elapsed, insurance may start to cover the pre-existing conditions, sometimes […]
The timely filling limit is the period between creating the claim by the billing agents and receiving it by the insurance companies. This period is determined according to the insurance regulation and guidelines. It also depends on the provider’s contract (in network or out of network). The period is between 60 […]
In this medical coding lesson, I will talk about the medical preventive services and will stress on the annual wellness visits, this service can be only provided once a year as it called annual checkup, therefore, the medical billing agent has to be sure that he […]
In this article, we will talk about the difference between medical PPM, ICD and ICM. We will stress on coding and billing issues for this cardiovascular service.
The following table indicates the medical billing codes for PPM, ICD and ICM services:
Facts about the PPM, ICD and ICM check: Restrictions of service: […]
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