Split Claims
This is selected as the "Type of Request" when requesting a split claim.
What is "Rebill - Date Range"?
This is a term used to state that a denial was received from a secondary payer when the primary payer's payment meets or exceeds that which the secondary payer would have paid had they been primary.
What is "Max Allowed"?
This is the balance necessary to move forward with Attorney Placement...
What is "$5,000"
Late Charges are posted to an encounter after this occurs.
What is "Final Bill Drop"?
This is the number of Rebills that can be requested per day.
What is "one" rebill?
This type of plan does not qualify for Medicare Cost Reporting.
What is Medicare Advantage Plans?
This is the activity code used for an Attorney Placement request.
What is 367?
Late Charges will directly impact our reimbursement rate under this type of reimbursement methodology.
What is "If insurance is to pay % of Billed Charges"?
This is selected for the "Override UB Frequency" if this is the first claim going out to the insurance.
What is "Blank Line - Clean Claim"?
This T-Code is used if a patient is QMB and does not have a secondary insurance to cover the assigned patient responsibility...
What is "W219"?
This is the status code used for an Attorney Placement request.
What is 522?
Late Charges will be written off when the payment is based on this type of reimbursement methodology.
What is "Per Diem"?
This is selected for the "Override UB Frequency" if we have received a denial.
What is "7 - Replacement of a Prior Claim"?
These types of accounts, regardless of the primary payer, do not qualify for cost reporting...
What is "Outpatient"?
This Level 2 Payer Issue Code is used when placing an Attorney Placement Request.
What is "ATPN"?
This is the bucket where late charges would post if written off in the Patcom system.
What is "Patient or Bucket 5"?
These are the 3 most common reasons to split our claims.
What is Authorization, Insurance Termed Mid-Stay, or End of the Year Billing?
If a patient has a Medicare Advantage plan the secondary insurance denies for max allowed, an adjustment is requested using this.
What is "Non-covered T-Code associated with the payer that issues the denial"?
This is the estimated attorney fee for an account with a balance of $37,000.
What is $7,400?
This is the T-Code used to write off Late Charges for an Aetna PPO plan as primary.
What is W224?