Part B Insider (Multispecialty) Coding Alert
Duplicate Claims Can Cause Double the Trouble
PDF
Plus: Medical practices continue to boost IT budgets.
Medicare is just as eager to pay your claim as you are to collect them. That was the takeaway from CMS’s Angela James during a “CMS Provider Minute” compliance video released on Jan. 20. “When you submit a claim, Medicare pays the first submission of an approved claim, and the good news is that if you submit a clean, payable claim, you only have to do it once. In fact, we pay 90 percent of clean, payable claims within 30 days.”
If you don’t collect within a month, don’t resubmit just yet. “If the claim is an exact duplicate, we will deny it,” James said. “Instead of submitting a duplicate, you can easily check the status of a claim by going through your MAC’s electronic claims status inquiry tool, or by calling your MAC. You can get the contact information for your MAC from www.cms.gov.”
Exact duplicate claims are those that have the same health insurance claim number, provider number, service dates, type of service, procedure code, place of service and billed amount, she said.
In other news…
If you thought your EHR investment would be your last IT expenditure for a while, you could be wrong. Some 40 percent of providers polled for IDC Health Insights’ recent report said that their IT budgets are continuing to grow, with only 25 percent of them saying that money is going toward electronic health records (EHRs).
The “2015-2016 Healthcare Provider Technology Spend Survey” discovered that medical practices are investing in analytics and care management, as well as optimizing the business for accountable care participation, according to a Feb. 1 IDC Health Insights news release on the topic.
“This report documents the movement by providers to the 3rd Platform, and across cloud, mobile, and big data technologies, we saw providers making significant investment in 2015, with more planned for 2016,” said IDC Research Director Judy Hanover in the statement.
Related Articles
Part B Insider (Multispecialty) Coding Alert
- E/M Coding:
NGS Medicare: Majority of 99215 Claims Were Coded in Error
Use our expert tips to avoid the issues that plagued high-level claims. When payers announce [...] - Error Rates for Hospital E/M Codes Were Even Worse
Although the 65 percent error rate for code 99215 seems astronomical, the reality is that [...] - Patient Privacy:
Discover These 3 Common Ways That Practices Violate HIPAA
Hint: You should train your temps if they aren’t already hip to HIPAA. Now that [...] - CCI Update:
Watch for Corneal Ring Segment, Collagen Cross-Linking Bundles
Tip: You can report a Column 2 code with a Column 1 code – but [...] - Part B Coding Coach:
Answer These Top 3 Questions to Test Your Understanding of Chemotherapy Administration
When reporting multiple infusions, choose initial administration service code to represent the primary reason for [...] - Physician Notes:
Duplicate Claims Can Cause Double the Trouble
Plus: Medical practices continue to boost IT budgets. Medicare is just as eager to pay [...]