If you are not using an electronics record program with patient registry reports to balance and check reimbursements from HMOs, this site might contain some additional resources to tap in to. Press release and site information listed below. BD
Miami, FL 10/08/07 - Most physicians' offices deposit checks received from HMOs and other payers with no questions asked, without verifying fee schedules or analyzing how the claim was adjudicated. Millions in underpayments remain undetected. - Generally HMOs UNDERPAY claims coded with modifiers (see definition below) - HMOs' Adjudication System cannot correctly adjudicate complex coding - Medicare HMOs found in violation of Medicare Guidelines - HMOs appeal process is tedious and cumbersome A modifier is a code appended to claims to denote that the service rendered was altered. - Many times the use of modifiers impact the reimbursement amount paid. - Modifiers ensure the correct payment for services. - Thousands of daily claims issued are coded with modifiers.
Looking for an NPI number?
Free NPI Search At
www.accuchecker.comThe National Provider Identifier (NPI) is a unique identification number for covered health care providers.
Millions in Underpayments from HMO's
Accuchecker Website: http://www.accuchecker.com/
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