EFT = Electronic Funds Transfer Benefits of EFTs ■Funds are available faster ■Administrative costs are reduced ■Accounting Department can reconcile receivables ■Contribute to the Paper Reduction Act
Electronic Data Interchange (EDI)
EDI= Electronic Data Interchange EDI helps provide quick efficient exchange of healthcare information •EDI provides access to HIPAA compliant transactions ■270/271 Eligibility Response in real time from the CMS data center ■276/277 Claims Status Inquiry within one day from EDI
Medicare Acronyms
Medicare Acronyms searchable list Rural Health Clinics (RHC) Federally Qualified Health Clinics (FQHC) End Stage Renal Dialysis (ESRD) Fee-For-Service (FFS) Medicare benefits •QIO –Quality Improvement Organizations •COBC –Coordination of Benefits Contractor •QIC –Qualified Independent Contractor •WIC –Western Integrity Center •CERT –Comprehensive Error Rate Testing Contractor •RAC –Recovery Audit Contractor
Medicare Summary Notice (MSN)
MSN= Medicare Summary Notice (MSN) http://www.medicare.gov/navigation/medicare-basics/understanding-claims/understanding-claims-overview.aspx If you get a Medicare-covered service, you’ll get a Medicare Summary Notice (MSN) in the mail every 3 months. The notice shows all your services or supplies that providers and suppliers billed to Medicare during the 3-month period, what Medicare paid, and what you may owe the provider. This […]
Multiple Procedure Payment Reduction (MPPR) on Certain Diagnostic Imaging Procedures
MPPR=Multiple Procedure Payment reduction. 100% of most expensive procedure, and other similar procedures reduces by a certain percentage if done by same physician on same date http://cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM7442.pdf
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