|
|
Post by justdhogan on Aug 25, 2016 21:11:32 GMT -6
I've found a post that had some useful information on billing post op eyewear just wanted to reach out and see if anyone knew of a way to make it more streamlined. The post I am referring too was this one. crystalpm.proboards.com/post/2910/threadWe had some problems in the past and now need to go back and rebill for them. We have over a year worth it looks like. Anyone have an idea on length of "Timely Filing"? |
|
jess
New Member
Posts: 12 
|
Post by jess on Aug 26, 2016 9:27:01 GMT -6
Are you having a specific issue when billing? In regards to some the post I seen they mention the location code we created V2020d codes that allowed us to set a default for any code ending in d to auto fill location 12. Made it one less thing to remember when sending claims. As far as the basic vs deluxe frame we bill for both codes when a pt chooses a deluxe. This allows DMERC to cover full amount on the basic frame then the difference is sent under the deluxe code with a GA modifier showing the pt signed a ABN and is aware its not covered. (we collected any non covered up front, but still send all codes to DMERC). If I can help in any other way feel free to reach out.
Jessica Lewis
|
|
|
|
Post by KizerOpt on Aug 29, 2016 8:54:00 GMT -6
I've found a post that had some useful information on billing post op eyewear just wanted to reach out and see if anyone knew of a way to make it more streamlined. The post I am referring too was this one. crystalpm.proboards.com/post/2910/threadWe had some problems in the past and now need to go back and rebill for them. We have over a year worth it looks like. Anyone have an idea on length of "Timely Filing"? Medicare has a one year TF limit, but if you have filed and received a denial you may have time to do a DME reopening to correct. For DME claims, you have to watch not only for the 12 modifier, but add the ordering dr and dates of surgery. I still add RTs and LTs just to make sure that's not an issue. Hope this helps
Karen
|
|
|
|
Post by justdhogan on Sept 12, 2016 12:13:09 GMT -6
Is the location code 12? Because I thought 11.
|
|
|
|
Post by KizerOpt on Sept 12, 2016 14:08:48 GMT -6
Is the location code 12? Because I thought 11. 11 is for office, 12 is patient's home. DME wants 12, since the materials will be used there. Karen
|
|
|
|
Post by justdhogan on Sept 22, 2016 9:26:00 GMT -6
Ok thank you.
|
|
|
|
Post by vaderkty on Sept 23, 2016 7:32:33 GMT -6
Can they just allow a 24 B box in the CMS form insurance tab to add 12 instead of 11? We break our exam and materials separate because it is 2 separate providers, anyway. That would help out a lot since we were getting rejections for all materials claims but it never said why.
|
|
|
|
Post by KizerOpt on Sept 26, 2016 8:54:57 GMT -6
Can they just allow a 24 B box in the CMS form insurance tab to add 12 instead of 11? We break our exam and materials separate because it is 2 separate providers, anyway. That would help out a lot since we were getting rejections for all materials claims but it never said why. Pretty good idea, DME won't allow refractions anyway, so it would only be materials. All others could be default to 11. I have all my material codes set for 12 though, with no problems in any insurances.
Karen
|
|
|
|
Post by vaderkty on Sept 27, 2016 17:42:35 GMT -6
I have all my material codes set for 12 though, with no problems in any insurances. Which insurances do you take? We take ALL the government and the commercial plans available to us in Maryland. The State plans are pretty picky about the "11" thing. |
|
|
|
Post by KizerOpt on Sept 28, 2016 7:22:41 GMT -6
I have all my material codes set for 12 though, with no problems in any insurances. Which insurances do you take? We take ALL the government and the commercial plans available to us in Maryland. The State plans are pretty picky about the "11" thing. Same here. Commercial and government. I went back and checked my codes, haven't had any trouble since I set glasses codes for home.
Karen
|
|
