Paramedical
Paramedical receipts should show some basic details. List these receipt requirements: Any 3?
Details about service or supply
Details about the treatment or purchase date
Details about the provider or clinic
Details of a breakdown of the charges
What is the recent update on Braces rigidity?
Braces made from semi-rigid materials that provide structural support and maintain proper body positioning will also be acceptable
The member purchased 3 supplies as per the receipt, but only 1 supply is requested in KHI1 (member Eclaim). Kindly confirm whether the claim should be assessed based on KHI1 or the receipt.
Pay as submitted especially if the amount match the expense in the receipt
What does R&C stand for with respect to paramedical claims?
Reasonable and Customary
What is the maximum allowance for BPAP/VPAP/ASV package as per recent update?
$5000
The claim is billed for "Signatera" for charges $4500.00 from life labs. what is the action as per recent update?
Since we confirmed that Signatera is a genetic testing, we can decline.
What is the designation of this provider if it is mentioned as C.A?
Acupuncturist.
A claim as been submitted for bed rails, where there is no beds purchased in history what is the recent update on an action for this claim?
pend to confirm if the patient has hospital bed.
As per recent update on R&C for Orthotics. what is the new R&C?
$550
What is the pretreatment approval letter for a paramedical service?
0779
Who will win IPL 2026?
RRCCCBBBBBB!!!!
EE SALA CUP KOODA NAMDHU....
Psychology service received in data entered claim. nature of service is missing in KHI! screen.
what is the number of times can a claim examiner call the provider to get that information?
00000!!!!!
Ben has rejected the claim in history but member have again submitted the same claim (with different CIDE) how do we handle base and HCSA now?
we have to reject the claim again in base as R20 and pay in hcsa if it is eligible.
Dutch complete hormone panel test provided by ND provider and received in 7XX charges is $545.
which series do we assess this claim and do we apply R&C for this?
Assess in 5XX and as this is a test we would not apply R&C and pay by overriding OV02.
Assume eye exam was performed on 26 oct 2021 and patient is eligible to take that service every 24 rolling months. what is next eligible date?
26 OCT 2023
When do we use Reject 07 (R07) ?
To reject and to tell that this plan does not cover charges for completing forms or reports.
When is a sleep study NOT required?
For replacement machine claims.