Timing is Everything
This is the amount of days we must wait between sending an electronic claim and determining that we should submit a rebill for a no claim on file response.
What is 21 days?
This code is for requests which are similar to requesting an adjustment, but only for requesting a Bad Debt Packet write-off through Patcom.
What is Status Code 701?
This payer must be primary as part of the criteria for including on the bad debt cost report.
What is Medicare?
This denial reason would be grounds for appealing a secondary insurance, as it is typically obtained by the primary payer.
What is authorization?
This is the amount of days we must wait between sending a paper claim and determining that we should submit a rebill for a no claim on file response.
What is 30 days?
This code is used to receive approval if we are requesting a max allowed write-off in Patcom.
What is Status Code 512?
This primary payer is also known as Medicare Part C.
What is a Medicare Advantage Plan?
An appeal request must contain this backup regardless of they type of appeal.
What is a cover letter?
This is the maximum amount of time that we allow between receiving promise-to-pay information and contacting the insurance to determine where the funds were sent.
What are 14 days?
This code is used to label our follow-up as 'BD - REQUEST BAD DEBT WRITEOFF' and will push the account out one day for review.
What is Activity Code 698?
IPReports can be reviewed to find out where this primary payer has sent their remittance information to a secondary party.
What is Medicare?
This drop-down selection is made in the Appeals portal when backup or attachments are missing from a request.
What is a Additional Information Needed?
This appeal Activity Code is designed to allow one day between the appeal request and the Sr. ARA approval.
What is Activity Code 430?
This code is used for requesting all contractual adjustments and write-offs, and will push the account out one day.
What is Activity Code 597?
This primary payer does not automatically crossover to secondary insurances, and is their EOB is the most common rebill attachment needed.
What is Medicare Advantage?
This appeals status is what we search when we are pulling documents for appeals.
What is Backup Needed?
This is the amount of time we must wait from the Medicare Remittance date before submitting a claim to the secondary payer.
What are 30 calendar days?
This code is used for some write-off requests and will forward the account for manager review.
What is status code 500?
We would perform this action if Humana Medicare is primary and secondary denies for primary pricing applied.
When do we write-off for max allowed with W779?
We should always provide this document when a plan pays per CMG, or a percentage of CMG.
What is the CMG Pricer?