030625- 9696- 7583
Denied correctly, previously exhausted units on claim 021825-9489-1002
032025- 9552- 2994
6 encounters, 49-U3, correct, $1205.88
032425- 9866- 11169
032325-9282-3894 billed for H2036, G0481 or 80307 cannot be billed on the same day.
022525- 9498- 359
future date not allowed
Where are three locations where a provider can locate their PSVs?
ProviderConnect, Payspan, Faxback service
040425- 9648- 9181
Correctly denied, claim was paid on claim 04042025-9648-8319
041725- 9640- 2055
correctly denied, wrong coding (H2018 for all encounters)
A provider is submitting a claim for 1 unit of H0014 services and 1 unit of W7375 services. Will this claim be approved or will it deny? Why?
Will deny because these two codes cannot be billed on the same day
032825- 9450- 16658
GT Modifier not allowed for psych testing
We use this to check if specific codes are covered under a member's funding sources
MSAG
022125- 9482- 13141
Units exhausted on claim ending in 13426
032825- 9451- 874
Correctly denied, PRP per day limit previously met
032525- 9642- 7024
Denied due to H0015 being approved on claim ending in 23276
031925- 9497- 785
Not covered, POS
We use this to identify what to do about specific hold codes
Claims and Finance Look-Up Tool
041025- 9728- 9676
paid out on claims ending in 8435 and 8319
032125- 9499- 123
Denied multiple H2018s
021025- 10291- 1841
H2036 denied, lab approved
040325- 9841- 448
not covered due to DX
We use this to determine whether two CPT codes can be billed together or on the same day.
Multiple Services Grid
041025- 9728- 9676
How many units used in May 2025?
11 units
040825- 9661- 795
processed correctly
040425- 9648- 17949
Conflict of services denial
030425- 9647- 3103
Need to resubmit with correct dates/units
What are you most excited for this weekend?
:)