Filing insurance claims properly with insurance companies in today's world is very important for healthcare providers. Here are some of the common errors that can cause your claim to be canceled or postponed.
The second time you make a claim, state in the letter that this is not a duplicate, but a second request for payment.
Call and ask the insurance company that the patient is completely covered by the insurance company that the patient provided to you. You can get to know more about medical claims exchange online at https://www.cxcsolutions.com/.
Make sure you send claims to the correct operator. Some insurance companies have several addresses to be sent a claim for. Make sure you have the correct address.
Invalid procedure/modifier code
CPT codes and modifiers change every year. Make sure you use a code that is still valid for the date you billed the service.
This is the number required for claims made to doctors. Without it, your request may be rejected or postponed.
If the carrier determines that the service is not medically necessary, they must be prepared to appeal the claim with a record and case history for the procedure performed.
Service Not Covered
When reviewing benefits, always ask specifically that the procedures to be followed are covered. It will save you a lot of time if you find out in advance.
Medicare Secondary Payer (MSP)
All primary Medicare must be submitted and responded to before being transferred to the secondary payer. A Medicare benefit or payment description must be attached to a secondary payment request for consideration.