Wiki Hospital Billing

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debdebc

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We do hospital billing but Caresource insurance is denying stating that a modifier needs to be added. We have tried several different modifiers but all keep getting denied. Is there a certain modifier that needs to be attached to these, seen inpatient or outpatient, that may help us get these claims corrected and paid? We are an FQHC facility. Is there maybe certain codes that may need to be used in addition or other than? Thanks!
 
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I do hospital billing/follow up for Medicaid payers, including Caresource.

What code(s) are they asking for the modifier on? Also, what state are you in?
 
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sls314 said:
I do hospital billing/follow up for Medicaid payers, including Caresource.

What code(s) are they asking for the modifier on? Also, what state are you in?
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I am in the state of Ohio. It is mostly on the OBS codes. Thank you so much for replying to me! So appreciate any help you can give me!
 
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I am in the State of Ohio. It is mostly on the OBS codes. Thank you so much for replying to me! So appreciate any help you can give me!
 
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debdebc said:
I am in the state of Ohio. It is mainly the OBS codes that are being denied
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I'm in Ohio too - I'll have to take a closer look at our Caresource denials and see if we're getting the same types of denials.

I hadn't noticed it yet, but I'm out of my normal routine as I had been gearing up to work from home during the COVID changes.
 
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I really appreciate any help you can give me. I am also working at home. I hope this COVID gets better and all would be safe.
 
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sls314 said:
I'm in Ohio too - I'll have to take a closer look at our Caresource denials and see if we're getting the same types of denials.

I hadn't noticed it yet, but I'm out of my normal routine as I had been gearing up to work from home during the COVID changes.
Click to expand...
I really appreciate any help you can give me. I am also working at home. I hope this COVID gets better and all would be safe.
 
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