http://www.wpc-edi.com/reference/codelists/healthcare/claim-status-category-codes/ EDIT MAPPING FOR 277 IN THE ORDER OF CLAIM STATUS CODE https://www.emedny.org/hipaa/5010/transactions/crosswalks/Edit%20Mapping%20for%20277%20in%20the%20Order%20of%20Claim%20Status%20Code.pdf
Claim Status Codes
277 report claim status codes Health Care Claim Status Codes • ASC X12 External Code Source 508 Health Care Claim Status Codes convey the status of an entire claim or a specific service line. http://www.wpc-edi.com/reference/codelists/healthcare/claim-status-codes/
Aetna Secondary billing electronically
Yes, you can send Aetna secondary claims electronically! Since we support the HIPAA standard for electronic batch claims submission, we accept electronically submitted coordination of benefits (COB) claims. You can submit COB claims directly from: A provider who has received a remittance advice from the previous payer (provider-to-payer COB) The previous payer (Payer-to-payer COB) Not […]
COBRA information
http://www.cobrainsurance.cc/eligibility.htm
Denial Codes
Washington Publishing Company Denial Codes
POA standards from CMS website
POA Fact Sheet Interesting facts on using the POA indicator. Affected Hospitals: The Present on Admission Indicator Reporting provision applies only to IPPS hospitals. At this time, the following hospitals are EXEMPT from the POA indicator requirement: ❖❖Critical Access Hospitals (CAHs), ❖❖Long-Term Care Hospitals (LTCHs), ❖❖Maryland Waiver Hospitals, ❖❖Cancer Hospitals, ❖❖Children’s Inpatient Facilities, ❖❖Rural Health […]
Timely Filing Issues
Your business office missed the timely filing deadline by 30 days. The claim is filed and comes back denied. What do you do now? You have to make a decision – pursue the patient, write-off or appeal. If the coverage is from a managed care plan, your choices are narrowed to just two. The answer […]
The Most Common Health Insurance Claim Denials
Top twelve Insurance Denial reasons This is a listing from a website that sells denial letter templates. They do have some good information on what to look for (and use to defend) any appeal for a denied insurance claim.
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