Author: Billin_Admin

This reimbursement policy applies to services reported using the UB04 claim form or its electronic equivalent or its successor form. This policy applies to claims submitted on such forms by network and non-network facility emergency departments (including hospital emergency departments) and free-standing emergency departments (UB Claims). Codes: 99284 99285 99291 99292 G0383 G0384 IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible for submission of accurate claims. This reimbursement policy is intended to ensure that you are reimbursed based on the code or codes that correctly describe the health care services provided. UnitedHealthcare reimbursement policies may use Current Procedural Terminology…

Introduction: In the complex world of healthcare, accurate coding is essential for proper documentation, billing, and reimbursement processes. Two widely utilized coding systems in the United States are HCPCS (Healthcare Common Procedure Coding System) codes and CPT (Current Procedural Terminology) codes. While both systems serve the purpose of coding medical procedures and services, they differ in terms of their scope, structure, and application. This article aims to provide a comprehensive overview of the differences between HCPCS codes and CPT codes and their significance in healthcare management. HCPCS Codes: The Healthcare Common Procedure Coding System (HCPCS) was developed by the Centers…

Medicare Advantage plans, also known as Part C, are a type of health insurance plan offered by private companies approved by Medicare. They provide all the coverage of Original Medicare (Part A and Part B), as well as additional benefits like vision, dental, and prescription drug coverage. In this article, we will discuss the top 10 Medicare Advantage plans. Medicare Advantage Plans Humana: Humana is one of the largest Medicare Advantage providers in the United States. They offer a variety of plans, including HMO, PPO, and Special Needs Plans (SNPs). Humana plans often include additional benefits like fitness programs, wellness…

As of 2023, the field of urgent care medicine has continued to grow at a rapid pace, driven in large part by the increasing demand for high-quality, accessible healthcare services. To meet this demand, healthcare providers have increasingly turned to electronic medical records (EMRs) as a means of streamlining and improving their operations. Urgent care EMRs in 2023 have come a long way from their predecessors just a few years ago. Today, these systems offer a wide range of features and capabilities that are specifically designed to meet the unique needs of urgent care providers. REF: Compare Urgent Care EHR…

Effective claims follow-up with insurance refers to the process of ensuring that claims for medical services are properly submitted, tracked, and resolved in a timely manner. This includes submitting claims as soon as possible after services are rendered, using the correct ICD-10 and CPT codes, adhering to billing regulations and guidelines, following up on denied or unpaid claims, and keeping accurate and organized records of all claims. It also includes open communication with the insurance company and patients to ensure that everyone is aware of the status of the claim and any necessary next steps, and using medical billing software…

Today you will find The BCBS Alpha Prefix List from ZAA to ZZZ. The alpha prefix is very important to the identification number. The prefix acts as a key element in confirming the members’ eligibility and coverage information. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield Plan for processing. Most members with coverage through a Blue Cross Blue Shield Plan are assigned a Three Letter alpha prefix as a part of their unique identification number. The alpha prefix can easily be identified as it is the first three characters. Some identification cards may…

Today you will find The BCBS Alpha Prefix List from YAA to YZZ. The alpha prefix is very important to the identification number. The prefix acts as a key element in confirming the members’ eligibility and coverage information. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield Plan for processing. Most members with coverage through a Blue Cross Blue Shield Plan are assigned a Three Letter alpha prefix as a part of their unique identification number. The alpha prefix can easily be identified as it is the first three characters. Some identification cards may…

An out-of-network provider is a healthcare provider or facility that does not have a contract with your insurance company. If you receive care from an out-of-network provider, you may be responsible for a greater share of the cost. The customary rate for an Out of network claim is the rate or amount that is typically charged by providers for a specific service or procedure in a specific region or state. Out-of-network usual, customary, and reasonable (UCR) rate is the amount that healthcare providers typically charge for a specific service or procedure in a certain geographic area. It is used by…

Today you will find The BCBS Alpha Prefix List from XAA to XZZ. The alpha prefix is very important to the identification number. The prefix acts as a key element in confirming the members’ eligibility and coverage information. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield Plan for processing. Most members with coverage through a Blue Cross Blue Shield Plan are assigned a Three Letter alpha prefix as a part of their unique identification number. The alpha prefix can easily be identified as it is the first three characters. Some identification cards may…

Today you will find The BCBS Alpha Prefix List from WAA to WZZ. The alpha prefix is very important to the identification number. The prefix acts as a key element in confirming the members’ eligibility and coverage information. Prefixes are also used to identify and correctly route claims to the appropriate Blue Cross Blue Shield Plan for processing. Most members with coverage through a Blue Cross Blue Shield Plan are assigned a Three Letter alpha prefix as a part of their unique identification number. The alpha prefix can easily be identified as it is the first three characters. Some identification cards may…