Wiki Resubmitting Claims

[jinitshah712@gmail.com]

Hi,

First of thank you for reading my question. I am new to billing.

Scenario 1- We billed 4 procedure line out of which only three got paid. My questions are,

1) When i resubmitting the claims to insurance should I submit all 4 lines again or just one which didn't get paid?
2) How would I resubmit above claim?

Scenario 2- When claim come back with the patient has Deductible and Co-insurance, I am aware that Co- insurance has to be send it to Secondary insurance. My questions are,

1) When it comes to Deductible, Should I transfer that to Patient Liability?
2) Should I bill Total Amount (Co-Insurance and Deductibles) to secondary insurance.

Please advise.

Jinit

 

[MARYELLENG]

I only submit the code that was denied. If you are correcting the claim, use the original claim number and resubmission code 6 or c. We always send the deductible to the secondary ins. For payment. If you drop it directly to the patient, they always call and request it anyway. Some plans pay deductibles others do not.