ICD-10

ICD-10 CM/PCS Procedure Basics And KPI Assesment ICD-10 CM/PCS (International Classification of Diseases, 10th Edition, Clinical Modification/ Procedure Coding System) consists of two parts: ICD-10-CM (diagnosis coding) was developed by the Centers for Disease Control and Prevention for use in all U.S. health care settings. Diagnosis coding under ICD-10-CM uses 3 to 7 digits instead of the 3 Read More →

ICD-10 transition

ICD-10 Transition Basics for Small and Rural Practices ICD-10 Transition deadline was on October 1, 2015 – the health care industry transited from ICD-9 to ICD-10 codes for diagnoses and inpatient procedures. ICD-10 Transition means everyone covered by HIPAA must use ICD-10 codes for health care services provided on or after October 1, 2015. Below Read More →

EDI UB-04 Claims

EDI UB-04 Claims Procedures (Security Health Plan) EDI UB-04 Claims processing procedures: EDI UB-04 Claims completion for inpatient and outpatient services billed by hospitals, skilled nursing facilities, home health agencies and other institutional providers (Continuation). 51. Health plan ID – Providers’ current Medicare Provider Number. 52. Release of information certification indicator – This field indicates whether the Read More →

Claims processing procedures

Claims Processing Procedures: UB-04 Security Health Plan Claims processing procedures: UB-04 claim completion for inpatient and outpatient services billed by hospitals, skilled nursing facilities, home health agencies and other institutional providers (Continuation). 37. Unlabeled 38. Subscriber name and address – The name and address of the party responsible for the bill. This information must be Read More →

Claims Processing Procedures

Claims Processing Procedures: UB-04 Security Health Plan Claims processing procedures: UB-04 claim completion for inpatient and outpatient services billed by hospitals, skilled nursing facilities, home health agencies and other institutional providers (Continuation). 9. a – Patient address – Full mailing address of the patient. (Required) 10. Patient birth date – The patient’s birth date must Read More →

Claims Processing Procedures

Claims Processing Procedures: UB-04 Security Health Plan Claims processing (UB-04 claim) completion for inpatient and outpatient services billed by hospitals, skilled nursing facilities, home health agencies and other institutional providers. The data elements are listed as fields on the claim form. Security Health Plan claims processing systems require that a complaint red form be used. If the Read More →

EDI Documents Transmission

EDI Documents Transmission Standards and Guidelines For Security Health Plan Partners EDI Documents Transmission guidelines state that Security Health Plan and the affiliated provider may electronically transmit to or receive from each other any of the standard transactions (collectively “documents”). All EDI Documents Transmission shall be processed in accordance with HIPAA standards and EDI Documents Transmission implementation Read More →

EDI Partnership

EDI Partnership for electronic data interchange (Security Health Plan) EDI Partnership supposes that Security Health Plan is unable to accept electronic transmissions of claims or other transactions set forth in the HIPAA Transactions/Code Sets regulations other than in the standardized format required by those regulations. If the affiliated provider transmits the transactions electronically to Security Health Plan using EDI Partnership, Read More →

EDI Trading Partnership

EDI Trading Partnership for electronic data interchange (Security Health Plan) EDI Trading Partnership supposes that Security Health Plan is unable to accept electronic transmissions of claims or other transactions set forth in the HIPAA Transactions/Code Sets regulations other than in the standardized format required by those regulations. If the affiliated provider transmits the transactions electronically to Security Read More →

Claims Submission

Claims Submission Test File Procedure (Security Health Plan) Claims Submission testing can be started once the username and password are assigned. Claims Submission test file may include any number of claims. Generally, trying to parallel a production run will yield the best test results. During the Claims Submission testing process, Security Health Plan will examine Read More →