A patient is registered in the system with his/her coverage details and then that patient's treatments are entered and updated in the system. These claims need to be sent to the patient's primary insurance.
This process of sending the charges to the patient's Insurance Company is called Filing Claims.
A service performed by the physician and entered in the system is called Charge but when the same charge is filed to that patient's Insurance Company, it is called Claim.
Claims may be sent in two ways:
Paper claims
Electronic claims.
Electronic claims are sent in ANSI/NSF Format. Paper claims are sent in CMS Forms-1500
Medicare Guideline posts
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- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation process - how often provide need to do - FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
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