Do you know about - Bundling curative guarnatee Codes - Stop Loosing Money To "Bundled" curative guarnatee Claims
Medical Insurance! Again, for I know. Ready to share new things that are useful. You and your friends.
What exactly is "bundling" anyway? It is when an guarnatee carrier combines two or more Cpt codes, substituting one overarching code, often ignoring modifiers along the way. This institution can cut down on your receivables. When codes are bundled, the codes are grouped together and the guarnatee carrier will only allow the fee schedule reduction for the one code that they feel is appropriate.
What I said. It isn't outcome that the true about Medical Insurance. You look at this article for facts about what you wish to know is Medical Insurance.How is Bundling curative guarnatee Codes - Stop Loosing Money To "Bundled" curative guarnatee Claims
There are ways to get around bundling. First you need to make sure you are billing the claim properly on the introductory submission. For example, if you are billing for an E&M code for a sick person who comes in with high blood pressure but the sick person is also complaining of knee pain and you end up doing an aspiration of the knee joint, then you need to make sure you use the definite modifiers to indicate what you are doing. You want to bill the E&M code, say it is a 99213, with a 25 modifier to indicate that it is a detach and obvious assistance in case,granted during the same visit. Then you would bill for the aspiration of the knee joint with the approved code using a 59 modifier to indicate a obvious procedural service.
It is quite vital to know the permissible use of all the dissimilar modifiers to get full repayment for your services. Also as foremost is the quality to read an Eob (explanation of benefits statement) correctly. Eobs can be fairly complicated and it is foremost to understand what the guarnatee enterprise did with the claim.
When the claim is processed and you receive the Eob you need to make sure the guarnatee enterprise allowed both codes separately. After all, you did an office visit to conduct to high blood pressure and you did the aspiration which was completely detach from the office visit.
If the guarnatee carrier bundles your codes you should file an appeal. In many cases the guarnatee carrier will reprocess the claim and unbundled the codes if you go straight through the petition process.
The petition does not have to be complicated. It can be a form letter that you fabricate where you just need to fill in the blanks. A lot of carriers bundle the claims on introductory processing because the majority of offices will not petition the claim. Just think how much money they save!
You may think that it's not worth the time to petition but you may be surprised if you knew how much money you absolutely lost over time. If you have a law in place to file the appeals that is a fairly straightforward process it won't take much time and you can increase your receivables. In my opinion, it is worth the effort.
Copyright 2007 - Michele Redmond
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