![]() ![]() To make tracking patient reimbursement easier, we can include these account numbers on our payment vouchers. Many offices assign their own account numbers to patients. Patient account numbers assigned by your office This includes claims for outpatient services and services performed by a hospital-based physician or other qualified healthcare provider. If you are a clinic or hospital-based physician or other qualified healthcare provider, use a CMS-1500 (02-12) form for claims for professional services and supplies related to: social security number, incomplete member number, transposed digits in member number). Incorrect member number: Provider billed with an incorrect member number (e.g.Date of current illness: The onset date was missing from box 14 in the CMS-1500 claim form.Codes: The person submitting the claim used invalid CPT/HCPCS, modifiers, or diagnosis codes.Physician Assistant: Supervising physician's name is missing for PA ( Note: A PA does not need to bill with a supervising physician if he/she is a Surgical Assistant and has completed the paperwork to be set up independently in our payment systems).Advanced registered nurse practitioner: Supervising physician's name is missing for non-credentialed and/or not contracted ARNP.Home IV drugs: NDC number and quantity is missing.Anesthesia time is billed in units to represent minutes and additional base units for the code. ![]() Anesthesia: The hours/minutes for anesthesia claims are not included.The claim rejects if records are not attached that support the change. Rebilling: Records are missing when rebilling with a different diagnosis or other change.Information doesn't match: Physician/provider information doesn't exactly match what is in our payment system. ![]() Here are common reasons why claims suspend or reject:
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