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    Sample claims

    I am teaching a Health Insurance and Reimbursement course at YTI and am looking for some sample notes/insurance info for students to practice filling in the claim forms. I can only do so much from my office as I am in a specialty so am looking for a variety of types of cases, payers, etc. We...
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    Aetna and denials for ICD-10

    Is anyone else having issues with ICD-10 and Aetna? I am in Pennsylvania and we keep getting denials for incorrect coding. I know they are the right codes as no one else is denying them. Any insight would be great!
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    Aetna's aquisition of Coventry

    Has anyone heard about how this is going to affect Health America plans who use Coventry? I can only find information in regards to Medicaid so far.
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    HCFA 1500 20-12 FORM and Medicare

    Has anyone else received denials regarding the new HCFA form? We started using the new form in March and are getting denials from Medicare stating that the provider information is missing or incomplete, but it is in the proper boxes. We are not having this issue with any other payers as of yet...
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    Negotiating Payer Contracts

    Not sure if this is the right place to put it, but I'll ask. What type of formula or what are you using to base your fee schedules on when negotiating the payer contracts. Some payers allow you to negotiate for a higher rate (not Highmark!) so we are trying to figure out some kind of base to...
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    HCPCS codes for anti inflammatory gels

    Hopng someone can give me a suggestion of two. We have billing anti inflammatory gels that we give to patients for home use between visits as A9270. I have been told that some WC and Auto will pay for them. I am racking my brain trying to find a correct code to bill. Of course the WC and...
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    Billing with a modifier for ExtraSpinal

    My doctors are now doing ExtraSpinal Manipulations (98943) as well as regular spinal manipulations. Should I attach a modifier to 98943? I have linked the specific ICD-9 code.
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    coding ART for chiropractic

    We are having issues with auto insurance reimbursement for ART being done by our chiropractors. They are certified to do it, but we keep getting denials. We are using code 99530 as there is no defined CPT code for it and including documentation when submitting. Anyone else having this issue...