F.O.R.C.E. Healthcare Resources, LLC (Founded on Regulatory Compliance and Ethics) Making Claims Correction November 14, 2012 1.

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Presentation transcript:

F.O.R.C.E. Healthcare Resources, LLC (Founded on Regulatory Compliance and Ethics) Making Claims Correction November 14,

About F.O.R.C.E.? Home Health Consulting Firm – Founded 2005 Services Provided: 1.Home Health Billing Webinars 2.Home Health Outsource Billing 3.Home Health Outsource Medical Coding 4.Home Health Billing Clean-up Projects 5.Home Health Operation / Process Consulting 6.Home Health Financial Consulting 7.Home Health CLIA Billing & Recovery Project 2

Contact Information F.O.R.C.E Healthcare Resource, LLC. –Website: Terri Ready, COO -Direct: ext Mobile: Lynn Alley, Billing Supervisor –Direct: Jonathan Sellers, Sales & Marketing - Direct:

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Claims Corrections From main DDE menu: -Choose Claims Correction/Option 03 -Home Health/Option 27 Allows claim corrections for DDE users Claim corrections needed before Medicare can process Also known as the RTP file 5

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Claims Corrections The S/LOC field will default to the status location T B9997 to display a listing of RTP claims or select a DDE Sort Option 8

Claims Correction DDE Sort Codes / Description -D – Sort by receipt date (oldest to newest) -H – Sort by HICN (ascending order) -M – Sort by medical record number (ascending order) -N – Sort by beneficiary last name (alphabetical) -R – Sort by reason code (ascending order) 9

10 Claim corrections screen sorted by receipt date

Claim corrections screen – sorted by reason code 11

Claims Corrections Claims correction notes: -RTP file will display up to 2,000 claims -If there are more than 2,000 claims, must correct claims in the file in order to display other claims -Claim has been successfully resubmitted when claim summary screen is displayed after pressing the PF9 key 12

Claims Corrections RTP Correction Tips: -If claims are not found on the RTP file, try verifying –HIC number –From and Through DOS –TOB submitted -If still having problems, (F3/PF3) to back out of claims correction –Go to claim inquiry menu –Enter HIC number and DOS to get status of claim –If claim not found, it may have to be resubmitted 13

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