@@PKRVibesCareerGrowth sir one doubt if we have PR50 denial only then we can chk ABN right? but since we have co-50 and coding is correct means then what need to do
@@parthasarathyvenkatachari2617 yes you have to check ✔️ ABN if services not covered scenarios. On denials CO 50 if coding team commented as already coded correctly, no further correction required. Then please go for Appeal on claim with complete medical records to prove the medical necessity 👍😊
Can we send corrected claim to medicare in medical necessity denial.. ( i was aware that we can never send corrected claim to medicare) .. Please correct me
Yes your thought is right. Irrespective of any denial or scenario, Traditional MEDICARE will never accept any corrected claims with resubmission code 7.
Same work flow like other Payers. Please note that we have work on Denials. Mostly denial work flow/ Denial management will not different from Payer to Payer.
1st check,if claim denied for emergencies room services, 1st check claim form is billed with pos 23 or not. If not bill with pos 23. If already billed with pos 23, call n probe the same on phone call and sent claim back for reprocessing. Note: if pt plan doesn't have ER benefits. Call n confirm the same and do bill pt.
If u have mentioned about lcd ncd guidelines u should teach us how to check on ncci edit tools
If you know about epic software, please share how to use it. when claims are denied , what to do, what & how to take action. And provide denial codes
Ping me at krushnareddy521@gmail.com
Open the eob there you find remittance code and denial reason based on that you should take action
Super sir , i got great information
Thank you.
@@PKRVibesCareerGrowth sir one doubt if we have PR50 denial only then we can chk ABN right? but since we have co-50 and coding is correct means then what need to do
@@parthasarathyvenkatachari2617 yes you have to check ✔️ ABN if services not covered scenarios. On denials CO 50 if coding team commented as already coded correctly, no further correction required. Then please go for Appeal on claim with complete medical records to prove the medical necessity 👍😊
What about commercial payers? How to check for them?
Mostly commercial payers not denied for this scenario. If they denied need to call payer for clarification
If coding correct... No chance of reprocess?
You can call payer, probe the same and reprocess .
Can we send corrected claim to medicare in medical necessity denial.. ( i was aware that we can never send corrected claim to medicare) .. Please correct me
Yes your thought is right. Irrespective of any denial or scenario, Traditional MEDICARE will never accept any corrected claims with resubmission code 7.
Your correct. Yes mentioned but you can correct to HMOs or managed care plans only. But for Medicare we can't do.
@@PKRVibesCareerGrowth sir i confirm with my senior they said we can only refile claim to insurance if correction done by coding.
@@pyarababu5194 yes only we refile but not as corrected claims. Your assumption is right. 👍
@@PKRVibesCareerGrowth thanks sir
Thank you
Welcome you 🤗
How to check abn signed or not by patient
Any provider will send notice to patient to sign ABN
Do you have any notes or video for Epic Software?
Hi Mukesh. I didn't have any video about any particular software yet.
How do we work for traditional medicare
Same work flow like other Payers. Please note that we have work on Denials. Mostly denial work flow/ Denial management will not different from Payer to Payer.
Bro can tell c040
1st check,if claim denied for emergencies room services, 1st check claim form is billed with pos 23 or not. If not bill with pos 23. If already billed with pos 23, call n probe the same on phone call and sent claim back for reprocessing.
Note: if pt plan doesn't have ER benefits. Call n confirm the same and do bill pt.