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Insurance Payments / BCBS DME Bilateral Billing
« Last post by mandaree23 on Today at 10:44:32 AM »
I am working some old appeals and need some help on billing to BCBS.  It appears that the claims were being billed to BCBS for L1907 and L1970.  Our previous billing company was sending them on one line item with RT and LT modifiers and 2 units.  They are only paying one unit with remark code N640 "Exceeds number/frequency approved/allowed within time frame."  Does anyone have any suggestions on billing these?

Thank you
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It does.  thank you so much for your help.  Have a great day.
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General Questions / Re: Dental Billing
« Last post by Sriram_Sub on Today at 09:15:16 AM »
Hi Billingbilling,

I don't have experience with Dental Billing. So unfortunately, I could not help. But I can see that the post has been read 12 times but no response yet from anyone in spite of the fact that we have a lot of experts in the group. So, I would think you should hit it straight to get good help on this forum.

Please post the actual question you have about dental billing so that people can share their ideas. Or if you are offering dental billing business to people in this forum, please mention that. I don't think you can get good help by asking if anyone has experience with Dental billing. JMHO.

Good luck.
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For the current charge, you may change the CPT and ICD code if the chart notes (by any chance) has been documented with some diagnosis other than Z00.00 or so. This way, we may justify that the patient was given a consultation for a problem and that it was not a AWV.

For your future AWV charges, I would suggest to have their eligibility verified so that the reps can advise if the patient is eligible to get a AWV consultation given for the year. Hope this helps.
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General Questions / Dental Billing
« Last post by Billingbilling on January 16, 2018, 09:26:41 AM »
Anyone have experience with dental practice billing?
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New! / Re: Medicare - CO151 - Payment adjusted because the payer deems the information
« Last post by tperian on January 16, 2018, 08:28:12 AM »
Thank you for your help.  Since the HPI states that the patient was here for his annual wellness check, i would not be able to re-code this visit as an E&M.  Correct?
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Medical Billing Software Reviews / Re: Suggestions for Billing Software
« Last post by Michele on January 16, 2018, 08:12:11 AM »
That sounds like a nice feature.  I have not used a software with that feature.
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If it is a scheduled appointment, you may verify benefits with the payer and see if your plan of Annual wellness care would be covered. By then, you would know if someone has already billed for that service during the same year.
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New! / Re: Medicare - CO151 - Payment adjusted because the payer deems the information
« Last post by tperian on January 16, 2018, 06:49:25 AM »
That is entirely possible.  How do we avoid this since the patient wouldn't know that is what the other physician charged?  Do you suggest we recode the claim and refile it or would it be better to cut our loss?
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Medical Billing Software Reviews / Re: Suggestions for Billing Software
« Last post by Billingbilling on January 15, 2018, 04:19:15 PM »
after you do the eligibility check, you can then have it copy the info for the demograhic/payer info directly.
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