Author Topic: Payment Groupers  (Read 1270 times)

jenhigh

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Payment Groupers
« on: October 26, 2015, 09:39:35 AM »
I am questioning payments on RFA codes 64633 thru 64636 for an ASC facility claim. What reimbursement group should they be paid from? Some insurances are paying for grouper 1 and others grouper 2.
« Last Edit: October 26, 2015, 09:44:10 AM by jenhigh »

pankaj

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Re: Payment Groupers
« Reply #1 on: October 26, 2015, 12:00:48 PM »
According me they should pay from grouper 1 and if any insurance is paying from grouper 2 you must call and try to reprocess the claim with correct grouper 1 because rates are higher in grouper 1. for more detail you can review https://www.colorado.gov/pacific/sites/default/files/CMS1500_ASC.pdf

*Please tell where the services were rendered for more specific help...

Best Regards
Pankaj Gangwani

jenhigh

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Re: Payment Groupers
« Reply #2 on: October 27, 2015, 08:15:36 AM »
These services are in Virginia.