Medical Billing Forum

General Category => General Questions => Topic started by: Brenda09 on October 23, 2011, 03:03:26 PM

Title: CAQH
Post by: Brenda09 on October 23, 2011, 03:03:26 PM
Hello Everyone,
 One of the physicians that I bill for sees several diabetic patients. She uses the G0246 and it gets denied saying not paid seperately. I told her it was for sensory or periphyl nerve loss, LOPS. If the patient has no nerve loss, she still wants it billed out even though it gets denied and her reason is because she has to document  that she treated the patient for their diabeties as a CAQH requirement. She said if she doesn't she is considered a bad Dr. with CAQH. I have never heard of this, but I haven't really done any research on CAQH. She said she has to follow up with the patient every three months, so she charges for this every three months when the patient comes in. Of course this doesn't help the AR's any. Would someone please shed some light on this. I would appreciate it.

Title: Re: CAQH
Post by: SLITTLES on October 24, 2011, 02:11:14 PM
Hi Brenda, the physician I work for bills items that are not paid separately all the time.  He wants to show that the service is being provided regardless of the reimbursement.  To keep the AR under control, we just bill it with $0.00 dollars.  Hope this helps.
Title: Re: CAQH
Post by: Brenda09 on October 24, 2011, 04:42:12 PM
Thank you, but unfortunately she thinks they should get paid and the amount gets charged out. I don't do the initial charge entry, that gets done in the office.
Title: Re: CAQH
Post by: SLITTLES on October 25, 2011, 06:36:42 PM
She may need to review some Bundling/Unbundling of codes to ensure she is billing correctly or otherwise the charges will be adjusted off when the payment comes in.