Bundling healing insurance Codes - Stop Loosing Money To "Bundled" healing insurance Claims

Health Insurance - Bundling healing insurance Codes - Stop Loosing Money To "Bundled" healing insurance Claims

Hello everybody. Yesterday, I discovered Health Insurance - Bundling healing insurance Codes - Stop Loosing Money To "Bundled" healing insurance Claims. Which may be very helpful to me so you. Bundling healing insurance Codes - Stop Loosing Money To "Bundled" healing insurance Claims

What exactly is "bundling" anyway? It is when an insurance carrier combines two or more Cpt codes, substituting one overarching code, often ignoring modifiers along the way. This convention can cut down on your receivables. When codes are bundled, the codes are grouped together and the insurance carrier will only allow the fee agenda allowance for the one code that they feel is appropriate.

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There are ways to get colse to bundling. First you need to make sure you are billing the claim properly on the introductory submission. For example, if you are billing for an E&M code for a sick person who comes in with high blood pressure but the sick person is also complaining of knee pain and you end up doing an aspiration of the knee joint, then you need to make sure you use the precise modifiers to indicate what you are doing. You want to bill the E&M code, say it is a 99213, with a 25 modifier to indicate that it is a cut off and definite service in case,granted while the same visit. Then you would bill for the aspiration of the knee joint with the accepted code using a 59 modifier to indicate a definite procedural service.

It is quite important to know the proper use of all the dissimilar modifiers to get full reimbursement for your services. Also as important is the ability to read an Eob (explanation of benefits statement) correctly. Eobs can be fairly complex and it is important to understand what the insurance firm did with the claim.

When the claim is processed and you receive the Eob you need to make sure the insurance firm allowed both codes separately. After all, you did an office visit to carry on to high blood pressure and you did the aspiration which was fully cut off from the office visit.

If the insurance carrier bundles your codes you should file an appeal. In many cases the insurance carrier will reprocess the claim and unbundled the codes if you go through the request for retrial process.

The request for retrial does not have to be complicated. It can be a form letter that you establish where you just need to fill in the blanks. A lot of carriers bundle the claims on introductory processing because the majority of offices will not request for retrial the claim. Just think how much money they save!

You may think that it's not worth the time to request for retrial but you may be surprised if you knew how much money you precisely lost over time. If you have a ideas in place to file the appeals that is a fairly straightforward process it won't take much time and you can increase your receivables. In my opinion, it is worth the effort.

Copyright 2007 - Michele Redmond

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