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Is it insurance fraud if a patient seen the nurse practitioner and the medical office billed that the patient seen the doctor?
Wiki User
∙ 12y ago
No, it's not fraud. The Nurse Pratitioner works under the doctors supervision and their visits can be billed out under the doctors name. (I've worked in medical practices for 20 years and this question comes up often).
Wiki User
∙ 12y ago
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What is involved in medical coding billing?
Medical coding is the first step in medical billing. The doctors will put the practices performed on a sheet in code. A medical coder will translate that code so that the appropriate person, the patient or insurance company, may be billed.
What is medical billing code 99443?
CPT 99443 is billed when an evaluation and management service is performed over the telephone by a physician or a nonphysician practitioner.
If the primary insurance allows more than the secondary insurance what would the secondary insurance pay?
Secondary insurance will not pay the claim but the remaining charges should not be billed to the member/patient. Provider of service should write off the patient responsibility that primary insurance applied.
What does bill type 131 mean?
bill type 131 is an out patient medical facility bill... billed on a UB
Can you appeal a medical bill that was improperly billed to your insurance which it still agrees to pay but it has gone on your credit?
Yes.
What is meant by primary and secondary insurance coverage?
Primary insurance coverage is what is first used when a medical service is being rendered. This is what will be billed first. Secondary insurance is supposed to cover what the primary insurance does not.
What is the difference between billing and billing coding?
In coding you take the patient medical record that has been transcribed by a medical transcriptionist and then the coder applies alphanumeric codes to the diagnosis, procedures, and supplies according to the corresponding reference manuals. Then, that coded record, goes to the biller to be billed to an insurance company for payment.
Offset scenario in medical billing?
Offset- It means adjustments of debts payments to be received against the credit payable. If there is a overpayment made by insurance company to the provider, then the insurance company will adjust by deducting the amount from other patient claim. For example : If the provider billed a patient claim for $250 and the actual allowed is $200, if the insurance paid $250.00 then the excess amount of $50 will be adjusted in another patient claim. Both are correct. Its the process of reversal of old claims and posting the amount to new claim.
What are the benefits of medical terminology in medical billing?
By understanding medical terminology and what it's referring to you can bill the person properly for that ever was performed for them. It can help further explain on what was done for the patient and how it is going to be billed. it also helps show the biller identify what are the things the patients are being billed for: medicines, treatments/surgeries, operation done, etc. Without knowing the medical terms being used, the communication between the biller and the medical facilty will not work well. If you're an aspiring medical practitioner or allied healthcare professional, then chances are you would be encountering tons of medical terms and abbreviations in your work. Without proper training, you'd be at sea every day. This is why you have to receive proper training whether for medical transcription or coding to familiarize yourself with the terminologies
If a married couple have medical insurance through each one's employer who's insurance pays the doctor bills first?
I have been a medical biller for over 10 years. It is always whoever is going to the doctor that one's insurance will pay. So, the husband goes to the doctor it is his insurance that would be the primary insurance and the wife's insurance could then be billed for the balance, i.e. copay, deductible, etc.
When a secondary health insurance plan does not cover the remaining balance is it the patient responsible?
Gererally speaking, the answer is Yes, after checking to make sure that the claim was billed using the correct diagnosis and codes.
Can you be billed for your medical bills if you were on a parent's insurance?
Being billed for medical services has nothing to do with insurance coverage, your parents or your own. Whether it is legal and appropriate to bill you would depend if you are an adult, if you signed the authorization form taking responsibility for the bill, and whether this was a workers compensation claim. If you are of age, you received treatment (not the insurance comapny) and are responsible for the bill. If you are not of age, your parents have legal responsibility to pay. Medical providers file insurance claims as a courtesy. If your insurance policy, or your parents', does not pay, you will have to. The debt would be turned over to a collection agency and would be reported on your credit report. It depends, if you had full coverage. Then NO, you are not responsible call you insurance and request a claim form follow the instructions on the form and submitt it, they should cover you medical bills.
