AAD: Avoid Duplicate Claim Submissions

The American Academy of Dermatology (AAD)  provides advice to avoid filing duplicate claims, which it says occurs in 6 percent of Medicare claim reporting. The common sense document includes the following tips, which help save Medicare and your practice money.

  • Understand the Medicare Internal Control Numbers (ICN) appearing on your Provider Remittance Notice (PRN). The ICN is a 14-digit “smart code” denoting how, when, and where the claim was received by Medicare, which uses the  number to track the region, method of claim submission, and the year and date the claim was received. ICNs are ideal ways to trace a duplicate problem.
  • Avoid automatic claim submission without obtaining the status of the original claim. Allow sufficient time for the claim to reach Medicare, for Medicare to process the claim, and for the PRN to reach you before re-filing the claim. Be patient and observant. If your software automatically refiles claims after a certain period with no response, disable this feature and do it manually.
  • Use modifiers 59, 76, and 78 appropriately. Check with your carrier to assure you are appending the right modifier for the right service.
  • When resubmitting a claim considered to be erroneously denied, resubmit only the denied charges. Some services might have been reimbursed, so note only those services unpaid on the resubmittal.

Read the full text on AAD’s Web site.

Certified Professional Coder in Dermatology CPCD

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