Acronyms
MPFS
What is the abbreviation for Medicare Physician Fee Schedule?
You would apply this adjustment when the Medicare claim you are working on requires a signed waiver from the patient prior to the services rendered; however, the signed waiver was not obtained.
What is the 3062 adjustment?
You would enter the fax number then add @concordsend.com in the TO field
How do I send a fax in Concord?
When Medicare AARP denies stating the claim needs to go to behavioral health, the records need to be faxed to AARP behavioral health. That is the only way they will accept them. Do not change these to UBH.
What is the proper way to send records to Medicare AARP Behavorial Health?
Moo
What does a cow say?
What is the abbreviation for Remittance Advice?
You would use this code because Medicare denied for records, but the records we sent were for the wrong date of service. Now it is too late to send new documentation.
Effective June 2020, Codes have moved out of LCDs and into these
What is Billing and Coding Articles
Molina only allows 90 days for us to do this. They should be sent via Fax to: (877) 682-2218; Attn: Appeals
What is the proper way to send a claim redetermination for Molina Medicare Complete?
Customer Service
Excellence
Professional Growth
Teamwork
Transparency
What are R1's values?
What is the abbreviation for Skilled Nursing Facility?
Only Jenny Brotherson is allowed to use this adjustment code after getting prior approval from the provider enrollment team.
What is 3154?
This is the website you use to check if the provider has been enrolled with the insurance yet.
What is https://care.newportcredentialing.com used for?
Instructions:
In a large pot, bring water to a boil....
What is the proper way to cook pasta?
You would do this after posting the Medicare contractual which causes a credit of $45.00, and you noticed the patient paid $45.00.
What is send a patient refund?
What is the abbreviation for American Association of Retired Persons?
When you are not sure which denial to use, this would be your first step
When do I refer to the Denial Adjustment Workflow handout?
According to the CRIT SOP, you should always check the timeline notes for this. In most cases the Status Date for the ‘Overpayment Resolution (CRIT) Team’ work item is the same date associated in the timeline notes.
What is Identify which provider(s) the audit is related to.
We used to call them huddles, and sometimes still do, but the proper name for them are this.
What is DRM?
This is the program I log in to in the mornings to work Levels 5-1 handoffs from the BSO
What is the R1D tool?
What is the abbreviation for Medicare, Medicaid, and SCHIP Extension Act ?
When you have had no response from a provider review for 60 days or more
When would I take the 3658 adjustment?
This is where you would use the Provider Billing NPI # found on Noridian’s portal to find the name, address, and phone# for the SNF the patient was in.
$10 for internet and $5 for your cell phone
What is the reimbursement for internet and phone?
Send to IWI 406 after researching the timeline notes
What should I do when I come across a Research Study account that has not been reviewed by Eldora (Dotti) McPhie?