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coverage

  1. T

    Wiki United Healthcare/Optum OON changes effective 7/1/21

    Hello, The SUD facility I work for is OON with this payer and was recently made aware that effective 07/01/2021 United Healthcare/Optum updated its coverage of OON benefits to exclude coverage of OON services provided outside of the member's "service area" Oddly the written announcement was...
    • TashaCPB
    • Thread
    • 07012021 benefits coverage coverageupdates fullyinsuredplans membersservicearea oon optum outofnetwork united healthcare
    • Replies: 0
    • Forum: Billing/Reimbursement
  2. E

    Wiki Medicare

    Hello, I'm in Michigan and a lot of the schedulers at the office I'm at have been scheduling Medicare annual visits too early...Medicare has to be 366 days after the last physical, correct? Now what about lab work. We have patient's who leave for Florida and like to get their annual lab work...
  3. J

    Wiki Eligibility Verification

    Does anyone have any good advice on the best way to set up auto-eligibility verification? Any examples of software applications that are really efficient? We are wanting to have an automated process that will generate a report for our persons served receiving Medicaid coverage. We are located...
  4. M

    Wiki NY State United Healthcare community dual coverage

    Just wondering if anyone else in physician billing getting a denial for an E/m billed with an X-ray as inclusive? When I called I was told the E/M is part of Xray and must bill E/M with 25 modifier. Looking for help, and or link for correct billing? New to dual coverage thru state
  5. C

    Wiki Therapy billing

    If an Occupational Therapist is out on vacation and a "PRN" OT is brought in for coverage, how is this billed to the carriers? Thank you.
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