Medical Billing Forum

General Category => New! => Topic started by: sathish7ily on September 20, 2016, 07:10:05 PM

Title: Need Resources
Post by: sathish7ily on September 20, 2016, 07:10:05 PM
Hi friends,

I'm new  to this medical billing. I'm very much willing to know about this field but don't have the resources to learn. I need some information.  Time Filing Limit of all major insurances ( Clean claim TFL and appeal TFL )

1. UHC
2. CIGNA
3. CAREFIRST
4. AETNA
5. DENTAQUEST
6. METLIFE
7. KAISER PERMANENTE
8. MCOs
9. MEDICARE


Clarify my doubt for what is MCO, HMO, PPO, EPO, POS. I know some basics of info about those like which needed PCP which doesn't.

I want to know how these plans are working out in insurance. I'm thinking insurance like UHC have MCO plan and PPO plan. Am I thinking correct. Please clarify this also. It would be very appreciated.
Title: Re: Need Resources
Post by: kristin on September 20, 2016, 07:36:43 PM
The resources you need you already have, I am guessing...a computer with an internet connection, and a telephone. Those are the resources I used when I needed to do research when I was first starting out in the billing world. Well, the internet was not available, come to think of it, but I have used constantly since it has become available to answer the questions you have asked, and more.

So my suggestion is you use the internet to look at the websites of all the insurance companies you have listed to get the info you need, and if you can't find the info you need on the websites, then get the telephone numbers from the websites for the insurance companies, and call them directly, and get the info from a representative.

Additionally, you can Google what  MCO, HMO, PPO, EPO, POS mean.

While I could just do the research for you, or tell you what I know already about what you have asked, that is a tall order, and not really the right way for you to learn. I am not adverse to clarifying something that you have already done research on, and need help further understanding, but to just spoon-feed you the answers doesn't help you at all.
Title: Re: Need Resources
Post by: PMRNC on September 20, 2016, 08:23:04 PM
Quote
Time Filing Limit of all major insurances ( Clean claim TFL and appeal TFL )

What you are asking is mostly about every plan benefit.. ERISA plans have their own timely filing. Timely filing limits are specified in an insured's plan policy benefit summary.