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Emblem
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Topic: Emblem (Read 3336 times)
Mandy1986
Newbie
Posts: 14
Emblem
«
on:
August 22, 2019, 01:01:35 PM »
Hi
i have discus something about a billing part for a patient currently with us. we are getting denial for her claim as DIAGNOSIS WAS OMITTED OR INCONSISTENT WITH PROCEDURE/REVENUE CODE
DX used for billing :DX1: F31.13, DX2: F43.10, F12.20
Revenue Code: 913
CPT :H0035
PHP-MH
Bill type:131
Can someone assist me ?
«
Last Edit: August 22, 2019, 02:21:35 PM by Mandy1986
»
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Mandy1986
Newbie
Posts: 14
Re: Emblem
«
Reply #1 on:
August 22, 2019, 02:20:07 PM »
Insurance Name : Emblem Health
https://www.emblemhealth.com/
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Michele
Administrator
Hero Member
Posts: 5927
Re: Emblem
«
Reply #2 on:
August 27, 2019, 04:54:03 PM »
It is not possible to tell based on the information below. Have you tried calling Emblem?
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Mandy1986
Newbie
Posts: 14
Re: Emblem
«
Reply #3 on:
August 28, 2019, 11:37:52 AM »
Yes, They told per there coder DX codes :F31.13, F43.10, F12.20 not support Revenue Code: 913 CPT :H0035, Bill type :131
it is hospital billing Mental health treatment center.
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Michele
Administrator
Hero Member
Posts: 5927
Re: Emblem
«
Reply #4 on:
August 28, 2019, 03:12:57 PM »
The dx codes are valid, the rev code is valid, and the type of bill is valid. There must be something about this specific plan that does not cover partial hospitalization for those codes.
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Medical Billing Forum
Re: Emblem
«
Reply #4 on:
August 28, 2019, 03:12:57 PM »
Nick D
Newbie
Posts: 40
Re: Emblem
«
Reply #5 on:
September 12, 2019, 01:26:09 PM »
Emblem will only accept Rev 912. Hope that gets you paid!
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OON Facilities Billing Manager
Mandy1986
Newbie
Posts: 14
Re: Emblem
«
Reply #6 on:
September 13, 2019, 12:12:10 PM »
thank you Nick D. Yes, It worked
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Nick D
Newbie
Posts: 40
Re: Emblem
«
Reply #7 on:
September 13, 2019, 02:46:13 PM »
Awesome
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OON Facilities Billing Manager
Medical Billing Forum
Re: Emblem
«
Reply #7 on:
September 13, 2019, 02:46:13 PM »
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Emblem