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: [...]
Medicare advantage plans contain 4 major categories are the following:
Medicare HMO plans [...]
Hospice is a program of care that covers patients who are terminally ill, and have 6 months or less to live if their illness runs its normal course while the skilled nursing program covers those patients who require a daily skilled service of a nurse, physical, occupational therapist or a [...]
The electrocardiogram (EKG or ECG) is a test that checks for problems with the electrical activity of your heart, while the echo test is an ultrasound test that can evaluate the structures of the heart, as well as the direction of blood flow within it.
Here, we will take [...]
Medical coder and medical biller are two separate jobs. However, usually the same person can do both of them in the provider’s office. There are many differences in the two jobs’ tasks. Mainly, medical coders are responsible for converting diagnosis to medical codes while billers are responsible [...]
Clearinghouse is service to submit medical claims to insurance companies electronically, however not all medical billers use clearinghouse and some prefer to use software to submit the medical claims directly from office to insurance.
Clearinghouse acts as mediator between medical biller and insurance company. It dispatches the claims [...]
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