KickCodes
If a payer pays per the contract, and it is applied correctly with a zero dollar balance. Which kickcode would you use?
RVCLOSE
Where would you open an Athena Case?
Support, Create Case or Call
We received a denial for an incorrect modifier. After updating the modifier, how would you submit a replacement claim in thena?
1. Advance view
2. Adding resubmission code 7
3. Adding the payers TCN #
4. adding kickcode: DRPBILLING
Who is the manager over our benefits/Auth team?
Julie Reinoso
What is FOI Tax id?
592929608
An EOB was received with an incorrect denial. The Ins was called and they are sending the claim back for review
REPROCESS
Where would you go to find an allowable amount for a CPT code ?
Claims, Allowable Schedule - select the year and NON FAC
Medical Records are being requested: What would you attach?
Differs for each service. Based on who answers..
Who handles any payment issues in Athena?
Payment posting
Who is the compliance officer and who is our HIPAA security officer?
Jennifer Rodriguez
If Athena indicates no record of payment but the EOB is on file. Contact Ins for void reissue of payment
CHECKLOST
Where would we go to perform an updated insurance eligibility check?
Quickview, Insurance
The maximum amount of units billed has reached its limit. What are your next steps?
Adjust according to the EOB.
If a payment is posted to the incorrect payer, who would fix that?
Athena- Submit an Athena case.
Who is our VP of Revenue Cycle
Michael Lombardi
The Insurance has denied the claim for not medically necessary and additional documentation submitted
CLIENTAPPEAL
What is FOI number for Athena?
18802
Claim denied due to provider not contracted- how would you work this claim?
Reach out to Manage care to validate
Adjust the claim if it is valid.
If you had an issue with Paycom, who would you contact?
Human resources can reset passwords and assist with paycom issues.
What is FOI's Legal Name
Musculoskeletal Institute Charter
When a claim is mailed and Justin sends the claim USPS
CLMBILLED
How do you add an EOB to a claim in Athena?
1. Financials
2. Remittance
3. Submit remittance
4. Select ERA or EOB
5. Choose file.
Commonly known modifiers?
LT
RT
KX
KV
50
JW
JZ
97
GA GZ
CO CQ
Who would you contact for an Auth for DME? Group?
FOI: DME Auth
OSTB:Stella
FSOSM: Megan
AFO: AFO DME Team
OAWF: Tabitha
Which groups are under the Orthocare umbrella?
All Florida Orthopaedic Associates - AFO
Brandon Orthopedic Associates - BOA
Florida Sports Orthopaedic and Spine Medicine - FSOSM
Orthopaedic Associates of West Florida - OAWF
Orthopaedic Specialties of Tampa Bay - OSTB