Jan S Plummer
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Identifying Duplicate Claims- best practice
Recently duplicate claims for lab services have been identified by reviewing claims for a large self-insured account. WE also conducted a survery of physician practices to determine whether they billed for lab or allowed their contracted labs to bill for the lab testing. The results were all over the board. Sometimes the physician office bills for the labs they do, other times both the lab and MD office billed for the same codes. Does anyone have a best practice for placing an edit in the claims sytem in order to avoid paying for duplcate CPT codes when two different providers bill for same services on the same day? Thank you.
Jan Plummer
Recently duplicate claims for lab services have been identified by reviewing claims for a large self-insured account. WE also conducted a survery of physician practices to determine whether they billed for lab or allowed their contracted labs to bill for the lab testing. The results were all over the board. Sometimes the physician office bills for the labs they do, other times both the lab and MD office billed for the same codes. Does anyone have a best practice for placing an edit in the claims sytem in order to avoid paying for duplcate CPT codes when two different providers bill for same services on the same day? Thank you.
Jan Plummer
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