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How to Bill Med-Pay Direct communication with the adjuster before you submit the first billing is critical. Obtain the fax number and ask if you can send your 1st billing with detailed information to help the claims adjuster process your claim. Claims adjusters like anything that makes their job easier.
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2. Step 1 Type yourself a cover page using this format
Step 1 Type yourself a cover page using this format. You MUST include the line, “Please be advised that any balance that is not covered will be balance billed to your insured.”

3. Step 2 Include a signed copy of the Irrevocable Assignment of Benefits
Step 2 Include a signed copy of the Irrevocable Assignment of Benefits. This is the only way you can stop unscrupulous attorneys from stealing the med-pay benefit.
For details about this form,
see its training presentation.

4. You can find the Irrevocable Assignment of Benefits in the Doctors Forms Section of the website. It is in word format and you must type your Doctor’s name and address information into several placed on the form to customize it for your office.

5. Step 3 Attach the Symptoms Form the patient filled out at the first appointment.
For details about this form,
see its training presentation.

6. You can find the Symptoms Form on the WWW. HBTinstitue
You can find the Symptoms Form on the Website In Doctors Forms

7. “Using Supplemental Diagnoses”
Step 4 Attach the Diagnosis Form your Doctor filled out on the Initial visit. It will include all diagnosis for all body areas and body parts.
For help with attaching the diagnosis form to the HCFA1500, see the training presentation titled
“Using Supplemental Diagnoses”

8. Step 5 Attach the Rivermead Form
Step 5 Attach the Rivermead Form. This should have been filled out by the patient on Day 2 if there are symptoms of brain concussion.
For details about this form,
see its training presentation.

9. The Rivermead Form is also found on the website www. HBTinstitute
The Rivermead Form is also found on the website in Doctors Forms.

10. Step 6 Attach the Folstein Exam form (if applicable… brain concussion case)
For details about Folstein,
see the training presentation
for that form.

11. Step 7 Attach the form “Doctor’s Analysis of Mental State and Cognition”
For details about this form,
see its training presentation.

12. Step 8 Attach the form Epworth Sleepiness Scale
For details about this form,
see its training presentation.

13. Step 9 Attach the form Doctor’s Analysis of Sleep Disorder
For details about this form,
see its training presentation.

14. Step 10 . Finally, attach the doctor’s Exam Form that was done on the 1st visit.
HBTI does not provide an exam form since it is a personal decision for each doctor as to the type of tests and order to do them in.

15. Step 11 Print out your HCFA1500 forms copy “Supplement” onto it, attach all these forms, and Voila…you are ready to fax and get paid in full.

16. In Summary…
The cover page advises the claims adjusted that you are providing all necessary forms and information for the claim to be processed in a timely manner.
Therefore, there should be no significant delays in reimbursement.
You have given the claims adjuster the following information: Symptoms Form, Exam Form, Diagnosis Form, all Testing Forms (Rivermead, Folstein, Epworth), The Doctor’s Analysis Forms, the itemized billing on a CMS 1500 From, and the very important Irrevocable Assignment of Benefits.
Finally you alert the claims adjuster that there insured will be Balanced Billed for any portion of your claim they deny.

17. You will never have to call the claims adjuster a Turkey

18. You will no longer have this image of the claims department…

19. Claims adjuster really don’t do this with your claim forms…

20. You calmly wait a few weeks until this shows up in the mail.