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August/September 2010
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August/September 2010
» 2010 Academies cancelled
» Childhood immunizations
» Coding and billing update class
» Just Say No to antibiotics for colds and flu
» Correcting previously billed claims
» Diabetic lab values – last one in 2010
» Flu and pneumonia shots
» Formulary Update
» Generic copays
» Improving generic prescribing
» Questions about our incentive programs?
» Recent medical policy additions and revisions
» Medicare crossover
» NCQA payment
» Efficient administration with online tools
» Patient Profile can help
» Answers to questions about pharmacy benefits
» Comprehensive physical exams
» Priority Health Medicare physician reimbursement
» PIP measure targets
» Preventive care vs. diagnostic care
» Prior authorization for behavioral health visits removed
» Quality awards
» Record BMI during visit
» Reminder cards
» Smartphone app for ID cards
» Spine Centers of Excellence
» Surgical decision making tool available
» Labor Day Weekend system upgrade
» Vaccines for Children
» Questions?
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Correcting previously billed claims
When submitting a correction to a previously submitted paper HCFA 1500 claim, resubmit it with 7 in box 22 along with the original claim number.
To ensure that we process the claim accurately, please add a note in box 19 that indicates the reason for the resubmission. This will notify us that this is a corrected or replacement claim, and the claims examiners won’t deny it as a duplicate claim.
When submitting a correction to a previously submitted electronic 1500 claim, resubmit it with the appropriate bill code in the 2300 loop in the CLM 05 03.
To ensure that we process the claim accurately, please add a note that indicates the reason for the resubmission in loop 2300 NTE (segment) ADD (Qualifier).
When submitting a correction to a previously submitted facility claim (UB04), resubmit it with the appropriate bill type, changing the frequency to reflect the change.
Click here
for more information, including types of billing codes.
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