Practice Management Alert

Biller can fix many 'minor' errors

Medical offices may not need to file an appeal to correct a claim if the mistake is deemed -minor,- according to new rules from CMS. When an office commits a minor error on a claim, the biller can ask the carrier to reopen the claim so she can correct the problem--entirely avoiding the appeal process. With most carriers, minor errors will include basic typographical and clerical errors, says Marcella Bucknam, CPC, CCS-P, CPC-H, CCS, coordinator of HIM Certificate Programs at Clarkson College in Omaha.

Try this: If you get a denial from an insurer that contains a minor error, follow these three steps to determine if you can fix the error without appealing:

Check the provider manual: -It tells you how to appeal certain types of errors, and you should follow those directions exactly- if the manual addresses your specific problem, Bucknam says.

Check recent carrier bulletins and communiqu-s: Often, these announcements will contain information about processing problems the carrier is having. -If it [the carrier] is having a problem, [the bulletin] will tell you how to handle the reprocessing,- Bucknam says.

Call the carrier: If your appeal contains a minor error that is not covered in the provider manual or carrier bulletins, pick up the phone. Bucknam advises that you explain your troubles to the carrier representative, and the rep -will tell you how to handle the correction- without appealing.