The first most common billing error is duplicate claim

The first most common billing error is duplicate claim -...

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
The first most common billing error is duplicate claim, the cause a provider resubmits the claim if the initial claim has not been paid within 30 days. The solution to this error check the status of the claim before resubmitting, it could be in a pending status in the Medicare system for payment to complete processing. The second billing error is beneficiary eligibility, the cause the beneficiary Medicare number is invalid on a claim, or the beneficiary is not eligible to receive Medicare benefits. The solution to this error is screen the patient, verify the patient’s eligibility for what kinds of services that a patient can or cannot get. The third common billing error is improper diagnosis, the cause the diagnosis listed as primary was not a covered diagnosis for the
Background image of page 1
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: procedures performed. The solution would be to check the local coverage determination policy for a specific procedure; also the coder should familiarize their selves with the medical necessity and documentation requirement within the appropriate policies. The Medicare National Correct Coding Imitative controls the improper that lead to inappropriate payments claims. The coding policies includes coding conventions in CPT, Medicares national and local coverage and payment policies, National medical societies coding guidelines, and analysis of standard medical and surgical practice. CCI also prevents billing two procedures that could not possibly have been performed together. CCI is updated quarterly; CCI edits are used in the Medicare system to check claims....
View Full Document

This note was uploaded on 05/22/2010 for the course BUS 100 taught by Professor Dustingettel during the Spring '10 term at University of Phoenix.

Ask a homework question - tutors are online