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Wiki BCBS coding evaluation

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cmanion

Networker
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27
Location
Howell, MI
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One of my providers recieved a bcbs evaluation stating that he is billing too many 99214's. I know my coding has been correct on these claims, so I am not sure why BCBS is saying this. Does anyone have any insight on this, it woud be greatly appreciated. Thank you in advance
 
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Providers receive these kind of letters, often called comparable billing reports, when a payer determines that the provider is billing more of a higher level E/M than compared to his peers. It doesn't mean you're necessarily wrong, but you can probably expect audits to follow.
 
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Lindap@ezderm.com said:
Providers receive these kind of letters, often called comparable billing reports, when a payer determines that the provider is billing more of a higher level E/M than compared to his peers. It doesn't mean you're necessarily wrong, but you can probably expect audits to follow.
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Thank you for the information : )
 
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