Eligibility & Claim Status Operating Rules: Service Type Codes (STCs) Eligibility & Claim Status Operating Rules define some Service Type Codes (STCs) as “discretionary” in the CAQH CORE Eligibility & Benefits (270/271) Data Content Rules (CAQH CORE 154 & 260 Rules). For certain STCs, the patient financial data is not required to be returned for some benefits … Read More →
Coordination of Benefits (COB) Assistance By BCRC (Benefits Coordination & Recovery Center) Coordination of Benefits (COB) issues can be consolidated by BCRC (Benefits Coordination & Recovery Center) that will correct any possible issues on their end, or report to the contractor any issues that require action on the part of the contractor. The Contractor can verify whether Medicare claims … Read More →
Benefits Coordination & Recovery Center: Coordination of Benefits (COB) A Celerian Group Company Benefits Coordination & Recovery Center consolidates the activities that support the collection, management, and reporting of other insurance coverage for Medicare beneficiaries. The purposes of the Benefits Coordination & Recovery Center program are to identify the health benefits available to a Medicare beneficiary and … Read More →
CAQH CORE 259: AAA Error Code Reporting Rule (Eligibility & Claim Status Operating Rules) CAQH CORE 259: AAA Error Code Reporting Rule requires a health plan/information source to return a AAA segment for each error condition that it detects in a X12 270 request, as described in sections 4.3-4.5 of the rule. CAQH CORE 259: AAA Error Code … Read More →