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4969Re: [MedicalBillers] Re: URGENT CARE VISIT

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  • fami tab
    Feb 1 4:22 PM
    • 0 Attachment
      Thanks, Yes, that will help.
      Fami



      ________________________________
      From: Melinda <melindadocsmith@...>
      To: MedicalBillers@yahoogroups.com
      Sent: Mon, February 1, 2010 12:46:57 PM
      Subject: [MedicalBillers] Re: URGENT CARE VISIT


      It must be billed "in addition to basic service" (other E/M, CPT, etc.). It cannot be billed alone. Check out your CPT code book for exact language.

      Hope that helps!

      Melinda Brown, CMBS
      Ins Biller

      --- In MedicalBillers@ yahoogroups. com, fami tab <marmar623@. ..> wrote:
      >
      > Hello Everyone,
      >
      > Question: my friend billed insurance with the urgent care cpt code. All of their claim was rejected, no payment was received,
      > Any advised?
      > Appreciated,
      > Thanks,
      >
      > Urgent Care Office Visit 99058
      >
      >
      >
      >
      > ____________ _________ _________ __
      > From: Carol Roush <carollroush@ ...>
      > To: MedicalBillers@ yahoogroups. com
      > Sent: Fri, January 29, 2010 4:56:09 PM
      > Subject: Re: [MedicalBillers] Can I get help with calculating co-insurance and deductibles
      >
      >
      > the CPT code we use to bill speech therapy is 92507.
      >
      > --- On Fri, 1/29/10, Corri Baker <virtuous_gracious@ yahoo.com> wrote:
      >
      > From: Corri Baker <virtuous_gracious@ yahoo.com>
      > Subject: Re: [MedicalBillers] Can I get help with calculating co-insurance and deductibles
      > To: MedicalBillers@ yahoogroups. com
      > Date: Friday, January 29, 2010, 4:20 PM
      >
      >
      >
      > I understand that, I've worked at a few places like that. Check CMS or google RVU 2010. I'd also be more than happy to help you if you can't find them, take down my email and email me with questions or specific codes you need RVU's for.
      >
      > Happy Weekend,
      >
      > Corri
      >
      > ____________ _________ _________ __
      >
      > From: Carol Roush <carollroush@ yahoo.com>
      >
      > To: MedicalBillers@ yahoogroups. com
      >
      > Sent: Fri, January 29, 2010 4:10:58 PM
      >
      > Subject: Re: [MedicalBillers] Can I get help with calculating co-insurance and deductibles
      >
      > Unfortunately, my boss doesn't buy any books. We just do how she says to calculate the co-insurance. It's unclear to me and I don't want to ask her for she is not a patient person.
      >
      > Thanks for the help,
      >
      > Carol
      >
      > --- On Fri, 1/29/10, Corri Baker <virtuous_gracious@ yahoo.com> wrote:
      >
      > From: Corri Baker <virtuous_gracious@ yahoo.com>
      >
      > Subject: Re: [MedicalBillers] Can I get help with calculating co-insurance and deductibles
      >
      > To: MedicalBillers@ yahoogroups. com
      >
      > Date: Friday, January 29, 2010, 3:47 PM
      >
      > Also some carriers are now offering on their website for providers to go in and calculate how much they'll get paid and how much the patient will owe. I've seen more and more carriers here in my area offering that as a "perk." So you may check online with some carriers to see if they offer that tool.
      >
      > ____________ _________ _________ __
      >
      > From: Corri Baker <virtuous_gracious@ yahoo.com>
      >
      > To: MedicalBillers@ yahoogroups. com
      >
      > Sent: Fri, January 29, 2010 3:43:20 PM
      >
      > Subject: Re: [MedicalBillers] Can I get help with calculating co-insurance and deductibles
      >
      > what CPT code? each CPT code has an RVU (relative value unit) attached to it. You may ask your boss to buy you the RVU book (it's a easy simple way to find the values.) The RVU is how the insurance company pays you. Your contract rate is set in your contract, but the RVU's change. So when your claim goes in, you're paid according to your contract $56 an RVU. So however many RVU's that CPT is, you're contract tells them how much to pay. Clear or clear as mud? :)
      >
      > ____________ _________ _________ __
      >
      > From: Carol Roush <carollroush@ yahoo.com>
      >
      > To: MedicalBillers@ yahoogroups. com
      >
      > Sent: Fri, January 29, 2010 3:38:50 PM
      >
      > Subject: Re: [MedicalBillers] Can I get help with calculating co-insurance and deductibles
      >
      > I'm not sure what an RVU is. I just know that we bill $79 as our fee to the insurance. Then, our contracted rate is 56.00 for Aetna.
      >
      > --- On Fri, 1/29/10, Corri Baker <virtuous_gracious@ yahoo.com> wrote:
      >
      > From: Corri Baker <virtuous_gracious@ yahoo.com>
      >
      > Subject: Re: [MedicalBillers] Can I get help with calculating co-insurance and deductibles
      >
      > To: MedicalBillers@ yahoogroups. com
      >
      > Date: Friday, January 29, 2010, 3:03 PM
      >
      > Hi Carol,
      >
      > I'm confused. You're saying your contract rate is $56.00 an RVU? If this is the case then you'll have to get the RVU for the code you're billing, then you multiply the RVU by $56 to get the price you'll be paid by the insurance. Once you know what you'll be paid you can easily figure out the 10% the patient will owe just multiply it by 0.10.
      >
      > I hope I didn't misunderstand you,
      >
      > Corri :)
      >
      > ____________ _________ _________ __
      >
      > From: Carol Roush <carollroush@ yahoo.com>
      >
      > To: MedicalBillers@ yahoogroups. com
      >
      > Sent: Fri, January 29, 2010 2:51:13 PM
      >
      > Subject: [MedicalBillers] Can I get help with calculating co-insurance and deductibles
      >
      > Hello,
      >
      > I have a new task at my job. The way my manager explained it is quite confusing.
      >
      > So let's say the deductible is $250. The contracted rate is $56.00. After decuctible is met, co-insurance is 90/10%
      >
      > I went 56.00 x 4 = 224
      >
      > Can someone please explain the rest of the calculations to me after the $224 is calculated all the way to the 10% of the $56.00.
      >
      > I'd greatly appreciate it! Thanks!
      >
      > Carol
      >
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