WELLCARE CLAIM PAYMENT POLICIES

WELLCARE CLAIM PAYMENT POLICIES

Evaluation and Management (E&M) Services New Patient Visits: The AMA defines a new patient as “one who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice within the past three years.” Given this definition, if a physician bills a new patient…

Global Period

Global Period

Global Period is a time frame following surgery during which routine care by the physician i.e., all necessary services normally furnished by a physician [before (Pre-operative), during (Intra-Operative), and after (Post-operative) the procedure] are included in the reimbursement of the original surgery and they cannot be separately reported. Each CPT has a Global period status indicator…