Resubmission of claims with documentation

[DMK]

Blue Shield of California has started to only pay one unit on 97000 codes.  If I bill multiple units, they pay one unit only.  I can get more paid if I resubmit with "appropriate documentation".  Where do I mark on the paper claim "Resubmission w/ Documentation Attached"?  I keep getting claims returned as duplicates even though I am writing "documentation to support medical necessity attached" on line #23.  I keep seeing great stickers in the Amerifile catalog, but I don't know where they would go.  On the claim or on the envelope?

Is it just me, or are insurance companies tweaking their rules often to avoid paying for services?  And then it's next to impossible to find someone at the insurance company to talk to to verify their new requirements.

Please help!!!

Dina

[Pay_My_Claims]

http://www.thoracic.org/sections/career-development/practitioners-page/practice-tips/articles/tip15.html

Do you write corrected claim on the top of the HCFA 1500?

[DMK]

It's not a corrected claim.  I billed it correctly the 1st time, they reduced the units of service.  So it's a Resubmission with treatment notes attached.

[Pay_My_Claims]

it doesn't matter they will still view it as a duplicate
Anytime I have to send additional documentation Insurance companys ask me to send in another claim with *corrected claim* written on the top. this serve as an alert for them to review

[DMK]

Thank you!  I will try that on three claims today!!!

[Pay_My_Claims]

Yes and please let me know how it turns out. This is what was always told to me, and I hope it will resolve your situation.

[DMK]

Charlene,

Thank you! Thank you! Thank You!  That little tidbit of information allowed me to collect $280 so far!  These were correctly provided and correctly billed services that B/S arbitrarily decided to reduce. 

You're AWESOME!  (Doctor thinks so too!!!!)

Dina

[Pay_My_Claims]

You are more than welcome...glad I could help. Thanks for letting me know!!!