Medical Billing Forum

Billing => Facility Billing => Topic started by: grlwundr on October 09, 2008, 08:03:55 AM

Title: Itemization??
Post by: grlwundr on October 09, 2008, 08:03:55 AM
Hi Alice/Michelle,

I am a biller in an inpatient substance abuse treatment facility. Recently, my claims have been denied by BCBS with the following remark: "This claim could not be processed because itemization of dates, procedures and charges were not submitted."

Do I have to list every date of service individually? I have been billing the total service units. Would this have something to do with the statement from and through dates? Do I need to attach a separate invoice to the UB04?

Thanks for your help!!
Andrea
Title: Re: Itemization??
Post by: Michele on October 10, 2008, 05:54:06 AM
Andrea,
   The denial you are receiving is vague, to say the least.  I would call either the BC customer service line, or your BC provider rep, and ask for clarification.  There is no use guessing what it is they are looking for.  Make them tell you how they want the claim so you can get it right on all future BC.  Of course, then they will probably change the requirements!  LOL   >:(
Title: Re: Itemization??
Post by: grlwundr on October 10, 2008, 09:44:36 AM
Michele,

Thanks for the advice. I did contact the provider rep and was told that for each line of the UB04 there should be 1 service unit, one date of service and one charge. I explained to them that's what I've been submitting, but they said it isn't correct. I'm going to resub with the same info and see what happens.  :-\
Andrea
Title: Re: Itemization??
Post by: Michele on October 10, 2008, 01:45:00 PM
Gotta love this field!   ;D

Good luck!
Michele