PPO (preferred provider organization)
This plan is somewhat similar to indemnity plans. It offers you the freedom to access the doctor of your choice. (Costs are lowered within a given network however) If you travel outside the network, you will be forced to pay a copayment based on higher charges. In addition, you might also be forced to pay the difference between the fee and the amount covered by your specific health insurance plan.
POS (point-of-service)
A POS health insurance plan is one of the more expensive insurance plans to choose from. Within a POS health insurance plan, you have a primary care physician (PCP) who has the ability to refer you to other providers within the given health insurance plan. If your PCP refers you to a physician outside of the network, all or most of the bill will be covered by your POS plan. Within the POS plan you also have the option to refer yourself outside of the network. However, in such instances, you would have to pay coinsurance.
Medicare Guideline posts
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Top Medicare billing tips
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CPT 99201 Office or other outpatient visit for the evaluation and management of a new patient, which requires these three key components: a...
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Condition Codes 20 and 21, Occurrence Code 32 If an FI receives a completely non-covered claim with either a condition code 20 or a condit...
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This post has Most used J code list and we are constantly updating with example . If you are looking particular J code, use search button. ...
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Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee... -
FL 42 - Revenue Code Required. The provider enters the appropriate revenue codes from the following list to identify specific accommodation ...
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Procedure code and description 11400- Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion d...
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URIBEL- methenamine, sodium phosphate, monobasic, monohydrate, phenyls alicylate, methylene blue, and hyoscyamine sulfate capsule Uribel i... -
Procedure code and description 93224 - External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage;...
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CPT CODES and Description 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitr... -
Procedure Codes and Definitions 36415 Collection of venous blood by venipuncture - Fee schedule amount $3.10 - Private insurance pay upt...
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