PDP
THIS IS THE NEW AMT. WE WILL SEE FOR A PART - D OOP FOR 2027
WHAT IS $2400
A RESPONSE GIVEN WHEN AN INSURANCE DETERMINES NO UNITS/VISITS OR TIMELINE IS NEEDED AFTER SUBMITTING A PA
WHAT IS NAR
WHEN WORKING THIS PAYER - THESE ARE KNOWN AS...
D80.0 D80.2
D80.3 D80.4
D80.5 D80.6
D80.7 D81.0
D81.1 D81.2
D81.5 D81.6
D81.7 D81.9
D81.89 D82.0
D82.1 D82.4
D83.0 D83.1
D83.2 D83.8 D83.9
G11.3 G61.81
WHAT IS A MCR APPROVED DIAGNOSIS?
THE PROCESS INSURANCE COMPANIES USE TO DECIDE WHICH PLAN PAYS FIRST, AND WHO PAYS NEXT WHEN A PERSON HAS MORE THAN ONE HEALTH INSRURANCE POLICY
WHAT IS A COB
THE SUPPLY CODES WE BILL THAT ARE ASSOCIATED WITH MCR
BONUS: THE ONE CODE WE CAN BILL WITH SPECIFIC SCIG THERAPIES ON MCR ADV.
A4222
A4221
BONUS: A4211
THE DOCUMENT THAT MUST BE SIGNED WHEN BILLING MEDICARE FOR DENIAL THAT MUST BE DONE YEARLY
WHAT IS AN ABN
A PLAN THAT TYPICALLY STARTS 7/1-6/30
WHAT IS A FISCAL YEAR PLAN
PLACE OF SERVICE ON AN AUTH SHOULD ALWAYS BE LISTED AS...
- HOME (12)
WHEN READING A CLAIM - THIS LOSS IS KNOWN AS
TOTAL AMT PAID < COST
ING. COST > COST
WHAT IS PROFIT LOSS W/ PT PAY
WHAT IS 80%
CSI OH - TX IS KNOWN AS...
(HINT: USES NASH NPI)
WHAT IS A CENTRAL FILL
MCR PART C IS ALSO KNOWN AS...
AN ADVANTAGE PLAN
YOU CAN ONLY CATCH THIS WHEN RUNNING BENEFITS ON THE MCR SPECIFIC SITE - AND INDICATES WE CANNOT BILL THE "BUNDLED" CODE
WHAT IS A HOME HEALTH EPISODE
CSI TX
CSI CT
(HINT: USES SITE SPECIFIC NPI)
ETC... IS KNOWN AS
WHAT IS A DIRECT FILL
THE 2027 MCR DED AMT.