Showing Patient Payments in CMS 1500 guidelines form

Showing Patient Payments in CMS 1500 guidelines form

Most of the practices would collect copayments from the patient at the time service. Although it’s not a violation for participating providers to accept payment prior to rendering services, there are specific guidelines to follow, especially when reporting these payments. Additionally, some providers who accept assignment have a concern that Medicare issues partial checks to…

Reporting Principal and Interest Amounts When Refunding Previously Recouped Money on the Remittance Advice (RA)

Reporting Principal and Interest Amounts When Refunding Previously Recouped Money on the Remittance Advice (RA)

CMS was advised that the current practice of reporting principal and interest amounts for all related claims on the Remittance Advice (RA) as one lump sum amount was creating problems for the provider community since it was not conducive to the proper posting of payments. CR8485 instructs the MACs on how to report refunded principal…

Check Medicare Claim Status Online

Check Medicare Claim Status Online

Earlier the status of Medicare claims can be obtained only through automated phone system but now all Medicare contractors are working closely with CMS to integrate “Individuals Authorized Access to the CMS Computer Services (IACS)” to offer secure and fast access to beneficiary eligibility, claims status, online remittances, financial information, PQRS and eRx incentive details,…

Who is a fiscal agent?

Who is a fiscal agent?

A fiscal agent is a private contractor to the state, normally selected through a competitive procurement process, may operate the state’s MMIS (Medicaid Management Information System). A state MMIS fiscal agent contract status report is prepared quarterly from CMS central office following the input from regional offices. The report is usually prepared within 30 days after the…

Differences between Emergency and Urgently Needed Services

Differences between Emergency and Urgently Needed Services

An emergency medical condition is a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, with an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in: •  Serious jeopardy to the health of the individual or, in…

CMS eliminates the requirement for Independent Laboratory (ILs) to bill separately for each individual (AMCC) laboratory tests

CMS eliminates the requirement for Independent Laboratory (ILs) to bill separately for each individual (AMCC) laboratory tests

Effective for services on or after January 1, 2012, CMS eliminates the requirement for Independent Laboratory (ILs) to bill separately for each individual Automated Multi-Channel Chemistry (AMCC) laboratory test included in organ disease panel codes for ESRD eligible beneficiaries. Organ disease panels will be paid under the Clinical Laboratory Fee Schedule and will not be subject…

List of Specialty codes

List of Specialty codes

Specialty codes are used by CMS for programmatic and claims processing purposes. They are used in expenditure analysis. Medicare contractors use specialty code data to develop claims processing edits.The following list of 2-digit codes and narrative describe the kind of medicine non-physician practitioners or other healthcare providers / suppliers practice. Code – Non-physician Practitioner/Supplier/Provider Specialty…