Do you have a video on how to fix Medicaid error for example r03, G55 or ad1 I am new to the Medicaid world I am more so commercial now I am doing Medicaid something I just don't know how to fix the rejected error or is there somewhere I can find something or a book
We don't, but we will add that to our list! We are working on videos again, so hopefully it won't be too long a wait for us to cover your topic. Just keep an eye out!
Hi there, I had a question about denied claims. Let's say I sent out a claim on a date of service of 06/01 to a health insurance that has a timely filing of 90 days. If they deny the claim, do we only have until 09/01 to fix the claim and send it back? Or since we originally sent it out before then, the 90 days resets to the denial date? Thank you!
You're very welcome! :-) Hope all is well with you! Let me know if there are any other healthcare billing/admin questions that I can help answer for you.
I wish my hysterectomy was denied almost a year ago. My doctor misdiagnosed me with endometriosis and he pushed me to get the hysterectomy based on false symptoms and diagnosis 😢. My pathology result showed only two uterine polyps 😢
Yay!! Thanks 🤩 I’m so happy that you found it valuable. Please do let me know if there are any other videos you would like me to make that could help the team on the front end of the revenue cycle i.e. the front desk, verifications & etc.
'COB Denials' some payer has the information that member has another primary insurance but they dont have a clear information about that ig: may be that payer has already terminated. Can you please advise @@InleraU
Hi there, I had a question about denied claims. Let's say I sent out a claim on a date of service of 06/01 to a health insurance that has a timely filing of 90 days. If they deny the claim, do we only have until 09/01 to fix the claim and send it back? Or since we originally sent it out before then, the 90 days resets to the denial date? Thank you!
Hi Robert! Sorry for the delay. With a basic claims filing limit you have 90 days from the Date of Service to get the claim into the insurance carriers system for adjudication (processing). For example, if the claim was sent but rejected at the clearinghouse level and you didn't refile (resubmit) until after the 90 days your claim will not be paid. There is also a timely filing for appeals and reconsideration of claims and that is the timeframe to send in an appeal from the date of the original EOB. That date is tycially different from the claims filing limit.
@@InleraU Thank you! I've learned so much more from watching your videos than I have from my managers at my job as a payment poster and medical biller!
Rejected claim can be appealed? Actually I asked insurance to reprocess a rejected claim,but audit team gave an error to me . Thy are asking me to appeal it. How can a claim can be appealed without denial...? I think reprocess is the best way for rejection.. I kept rebutal on this to auditor Kindly hlp me on this
That is correct. They misinformed you. Rejected claims cannot be appealed as appeals can only be submitted for claims that have been accepted for adjudication. You can and should correct the claim and submit it with the proper claim frequency code as either "corrected" or "replacement" claim. I hope that helps!
You are so very welcome! Thank you for your willingness to learn! :-) Let me know if there is topic, in particular, you would like to know more about in the business of healthcare.
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Do you have a video on how to fix Medicaid error for example r03, G55 or ad1 I am new to the Medicaid world I am more so commercial now I am doing Medicaid something I just don't know how to fix the rejected error or is there somewhere I can find something or a book
We don't, but we will add that to our list! We are working on videos again, so hopefully it won't be too long a wait for us to cover your topic. Just keep an eye out!
Hi there, I had a question about denied claims. Let's say I sent out a claim on a date of service of 06/01 to a health insurance that has a timely filing of 90 days. If they deny the claim, do we only have until 09/01 to fix the claim and send it back? Or since we originally sent it out before then, the 90 days resets to the denial date? Thank you!
I like your short and precise answers in very simple terms and in the short time span where listeners attentively are sharp and eager.
Thank you, I am glad you found it helpful.
This is truly an useful differentiation that a healthcare guy should know. Nailed it !!
Sweet!! Thanks for the input 🤩 Glad you found it helpful!
This is very helpful.My claim got denied because of preexisting condition(kidney stones).Can I able to appel without denial.Any help is appreciated
You can try to appeal or request reconsideration with proof that the condition was in existence prior, if there is truth to that statement.
Great job with explaining the difference between Claim Denials vs Rejection.
Glad you liked it! ;-)
WOW, thank you so much! Awesome video :)
You're very welcome! :-) Hope all is well with you!
Let me know if there are any other healthcare billing/admin questions that I can help answer for you.
Thank you so much
You're most welcome
Do you have anything that would help me with no fault and workers comp denial?
Thanks for your comment! Could you expand a bit on the situation and I will see if I can help?
I wish my hysterectomy was denied almost a year ago. My doctor misdiagnosed me with endometriosis and he pushed me to get the hysterectomy based on false symptoms and diagnosis 😢. My pathology result showed only two uterine polyps 😢
I'm so sorry to hear that!
Hello mam,can you explain about rejections types of rejections and what action to take how can call for rejection details etc.,
Hi Vinodh, Thank you, I will add these topics to my lists.
Jasmine - Great information. My team will definitely benefit from these descriptions and differences.
Yay!! Thanks 🤩 I’m so happy that you found it valuable. Please do let me know if there are any other videos you would like me to make that could help the team on the front end of the revenue cycle i.e. the front desk, verifications & etc.
I worked for claims rejections and AR (claims denials).
Need your help more in claims denials.
Sure! Please share what denials you are struggling with.
Me also
'COB Denials' some payer has the information that member has another primary insurance but they dont have a clear information about that ig: may be that payer has already terminated. Can you please advise @@InleraU
Tysm
Most welcome 😊
Hi there, I had a question about denied claims. Let's say I sent out a claim on a date of service of 06/01 to a health insurance that has a timely filing of 90 days. If they deny the claim, do we only have until 09/01 to fix the claim and send it back? Or since we originally sent it out before then, the 90 days resets to the denial date? Thank you!
Hi Robert! Sorry for the delay.
With a basic claims filing limit you have 90 days from the Date of Service to get the claim into the insurance carriers system for adjudication (processing). For example, if the claim was sent but rejected at the clearinghouse level and you didn't refile (resubmit) until after the 90 days your claim will not be paid.
There is also a timely filing for appeals and reconsideration of claims and that is the timeframe to send in an appeal from the date of the original EOB. That date is tycially different from the claims filing limit.
@@InleraU Thank you! I've learned so much more from watching your videos than I have from my managers at my job as a payment poster and medical biller!
Rejected claim can be appealed?
Actually I asked insurance to reprocess a rejected claim,but audit team gave an error to me .
Thy are asking me to appeal it.
How can a claim can be appealed without denial...? I think reprocess is the best way for rejection..
I kept rebutal on this to auditor
Kindly hlp me on this
That is correct. They misinformed you. Rejected claims cannot be appealed as appeals can only be submitted for claims that have been accepted for adjudication.
You can and should correct the claim and submit it with the proper claim frequency code as either "corrected" or "replacement" claim.
I hope that helps!
@@InleraU Do we need to send Corrected claim to insurance if our claim get rejected?
@@AllwaysJai override the scrube
Online class medical billing
Hi there! If you're looking for courses, we do have some available here:
ips-s-school-8c86.thinkific.com/collections
Got it thanks 👍🏽
Great!!
Great video.
Thanks Ashley! Do you have any healthcare revenue cycle or medical billing questions you'd like answered ?
Thank you so much for sharing your knowledge!
You are so very welcome! Thank you for your willingness to learn! :-) Let me know if there is topic, in particular, you would like to know more about in the business of healthcare.