By Alice Anne Andress
Davis's Notes e-book. Physicians, PAs, and NPs are all required to assign billing codes to the diagnoses they make and methods they practice. wrong coding may end up in unpaid claims or probably even accusations of coverage fraud. Provider's Coding Notes presents scholars, citizens, and practitioners an easy-to-understand reference for correct evaluate and administration (E&M) coding, documentation and medical health insurance info worthwhile for correct billing of clinical providers.
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Additional info for Provider's Coding Notes: Billiing and Coding Pocket Guide
If the unsigned check is from an established patient and merely an oversight, the practice should try to reach the patient and request that they stop by to sign the check. If it is difficult for the patient to return to sign the check, it can be handled in the following manner: ■ Write the word “over” on the signature line of the check. ■ On the back of the check in the endorsement area, write “Lack of signature guaranteed,” the practice’s name, and one’s own name and title. This tells the bank that the practice will accept the loss in such a case where the patient would not honor the check.
56 01Andress (F)-01 4/17/07 3:00 PM Page 57 Copyright © 2007 by F. A. Davis. 57 Nurse Practitioner (NP) Billing Important facts: ■ Federal law mandates direct reimbursement to pediatric (PNP) and family (FNP) nurse practitioners providing services to children. ■ Physician collaboration is not required within the federal mandate. ■ Each state will determine the reimbursement rate for nurse practitioners. Medicaid Billing Summary CMS-1500 form is used to submit claims Deadlines for processing claims is determined by each individual state A minimum Deductibles: of 45 days There is a must pass deductible before a for patients claim can be who are resubmitted.
GENERAL 01Andress (F)-01 GENERAL 4/17/07 3:00 PM Page 48 Copyright © 2007 by F. A. Davis. MSP Billing Guide Primary Insurer: Medicare Primary Insurance: Other Insurance The patient has coverage under a self-employed plan, such as real estate agents. ■ The patient is a member of the United Mine Workers of America. ■ The patient’s injury or condition is a result of a motor vehicle accident. ■ The patient’s injury or condition is a result of employment. Physician Assistant Billing Medicare pays the PAs’ employers in all settings at 85 percent of the physician’s fee schedule.
Provider's Coding Notes: Billiing and Coding Pocket Guide by Alice Anne Andress