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Recent content by ajf_92@icloud.com

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    EOB with Takebacks (OSCAR)

    Does anyone understand the terminology that Oscar used in the EOB when doing takebacks. I am seeing the terms refund request, offset, overpayment. While also seeing claims being taken back multiple times, but now I am starting to think that they are explaining the process of the take back. I...
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    Wiki Payment Posting--Copays

    Yes, there is an actual dollar amount for each PR-3. That is why I am confused because I thought the Copay was only collected once but from what the claim is saying it looks like they are collecting it multiple times on a single claim. I just started posting payments 2 months ago and so I'm...
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    Wiki Payment Posting--Copays

    an example would be patient was seen on 3/5/2025 copay was collected for $25.00, on the EOB it say to collect the copay for all 3 codes. 3/5/2025 99213 $0.00 PR-3 CO-45 3/5/2025 20610 $0.00 PR-3 CO- 45 3/5/2025 J1010 $0.00 PR-3 CO-45 My understanding is that the copay is only collected once.
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    Wiki Payment Posting--Copays

    Thank you for clarifying Susan, so even if I am seeing multiple copays being posted for the same patient on the same day, that is correct?
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    Wiki J1010 payment

    what if they are not doing bilateral?
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    Wiki Payment Posting--Copays

    Why do some of the EOB's , when posting payments, have PR-3 (copay) posted to be payed by the patient on all of the entries, when the copay is only supposed to be taken at the beginning of the visit?
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    Wiki J1010 payment

    I did some research on the J1010 code and the denials of payment I have been seeing at 160 units from multiple insurances at the practice I work at. I am seeing responses from some other billers that they have been getting denials also if they send the J1010 for 160 units. The CMS has only...
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