Part B Insider (Multispecialty) Coding Alert

Published on Thu Mar 03, 2011 PDF

Have trouble deciphering the Remittance Advice (RA) that your MAC sends to you? One carrier offers a riddle to let you know how to read the document.

"There is an age-old question, 'How do you eat an elephant?' The answer to which is 'one piece at a time.' The same applies to understanding the RA," says NHIC Corp., a Part B payer in five states, in its document Understanding the Remittance Advice. NHIC deconstructs the RA to show you exactly how to understand each particular section.

For instance: Under the header "COINS," the payer isn't telling you how many coins you get back--it's giving you information on the amount for which the patient is responsible, also known as "coinsurance." Typically, the coinsurance amount is 20 percent of the allowed amount for Part B beneficiaries, but that amount can change from year to year.

To read the entire primer on Remittance Advice, visit www.medicarenhic.com/providers/articles/Remittance%20Advice%20Educational%20Article.pdf.