Medical records not supported
What outcome do we use in IDX when we appeal for this flow
Pend appeal Med Nec/Non covered
What flow do we follow when Two providers billed two e/m codes on the same day
Doctor A/B flow
What application do we utilize to pull radiology records
Carestream or Sygno
What form letter do we use for late submission
form letter 350
what folder do we locate Bot responses
Sutherland folder found on the M-drive
Can we adjust E/M codes
Yes, first we must appeal and if the denial stands corrected we adjust
What document do we review for doc A/B flow
E/M situational guide
what coding tool do we utilize to determine if there are cci edits
Codify
What pay code adjustment do we use if the insurance info registered incorrectly and the invoice was in self or pending FSC passed carriers alloted timeframe and never billed to insurance
Paycode 8173
What does LMON medical terminology stand for
Letter of medical necessity
Note type 413
What form letter do we use if two providers billing two e/m's have two different specialties
Form letter 427
What application do we use for Hospital System for LIJ/Children's Cohens/Zucker Hill.
Eagle
If charges were entered passed the alloted time for initial claim submission and is greater than 1 k what is our action
We appeal utilizing form letter 350 before adjusting
What do we use Td bank for ?
Displays correspondence and EOBs sent from the carrier.
What paycode do we use to adjust E/m codes for this denial
We use paycode 8110
What paycode do we use to adjust if appeal denied
Paycode 8088
What application do we use to obtain operative reports for Staten Island & Huntington
Onecontent
If the charge correction was completed after the carrier's Allotted time to submit corrected claim what write off do we use
Write off using the paycode associated with the department that caused the timely submission
What application do we use to track electronically submitted claims
Ecommerce
Can we adjust procedure codes
No we can not, we must confirm we submitted accurate records and escalate to supervisor to add to tracker
When we bill a subsequent visit on the same day as a discharge visit what is your action
Write off the subsequent visit as bundled 8088 - Per NCCI Edits, subsequent visit is truly bundled to the E&M discharge.
what application do we use to update patient insurance/demographics, view authorization, view facility notes for Huntington Hospital and Staten Island University Hospital
Soarian
A recoupment is related to COB denial and claim not submitted within the allotted time what action are you taking
We are submitting an appeal with form letter 350, if appeal denied we adjust 8131
What document do we review for Non par/dealation providers
Balance billing Guidelines