Payment Notes
We should never tell the provider what ______ they should bill.
What is CPT code?
This code means the claim was submitted untimely.
What is the letter "P"?
Do we pay for time codes that are not built to the order?
No
When denying dental images due to images not received you use this Adjustment Reason Code.
What is letter "C"?
I can find any work instructions here.
What is the DMS?
Do not use all _____ letters in payment notes.
What are Capital?
This code means "Not Authorized".
A
When the Psych provider is billing for additional (not authorized) quantities of 96150 I use this Adjustment Reason Code to deny on a separate line.
What is letter "O"?
I use this denial reason code for when I am denying due to data mismatch on the tube.
This is the section in the provider contracts that pertains to us.
What is the Base Subcontractor Agreement? (Usually paragraph 6)
Refrain from using these payment notes.
What is ""____ was authorized" or "Please rebill using ____” Please rebill authorized codes"...
I have exhausted all search options and still cannot find the patient in the system. I deny with this letter.
What is letter "Y"?
When denying a medical opinion I use this Adjustment Reason Code.
What is letter "A" or Not Authorized?
A provider is billing more than one blood draw. I use this Adjustment Reason Code to deny the second one.
What is letter "U"?
I am processing a No Show in MedNet. This is what my check stub note should be.
What is the patients last name?
In the payment notes section always state _____ instead of ____.
What is NOT authorized instead of what was authorized?
This denial code should be used as a last case scenario denial choice.
What is the letter G?
I use this Adjustment Reason Code when denying something due to not being preauthorized by MEPCOM.
What is letter "Q"?
I am denying a blood draw. I find the denial reason here.
What are the order notes?
These are the two main things that you need to obtain when on the phone for HIPAA purposes.
What are Identification and Authentication?
When making additional denial/payment notes this is the appropriate format.
"_____is not authorized for ____"
OR
“This x-ray is not documented as being completed”
I use this Adjustment Reason Code when the provider is billing more than we pay.
What is code "45"?
When denying a time CPT code for VBA that was not authorized I use this Adjustment Reason Code.
What is Letter "O"?
When a provider is overbilling for a no show based what they have negotiated for another contract you state this in the payment notes ______.
What is "Contracted rate for RHRP no show is ____"
What is 25 characters?