tci Medicare Compliance & Reimbursement - 2012 Issue 15

Denial Management: Sidestep Billing Headaches By Checking Practitioner Specialty Enrollment

Dodge the 'no-pay zone' -- inspect your patients' insurance cards. If you MAC rejects a new patient code, you need to verify under which specialty your physician has been enrolled in Medicare. Once a practitioner has been assigned the wrong specialty in Medicare's systems, you are setting yourself up for all kinds of billing challenges and need to set the record straight ASAP. That's the word from a June 27 NGS Medicare \"Ask the Contractor\" teleconference, in which a caller presented the following scenario: Her internal medicine physician saw a new patient and reported a code from the 99201-99205...

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