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Published byJonas Dicken Modified over 9 years ago
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By FBC Services
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Medicare General Information Medicare A General Information ◦ NO-Pay and Benefit Exhaust Bills ◦ SNF Denial Information ◦ MSP Medicare Secondary Payer ◦ Assessments and OMRA’s Medicare B General Information ◦ What’s Covered ◦ Bundling and Therapy Caps ◦ 59 and KX codes
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DDE Information ◦ Claims Correction ◦ CWF Roster Billing Questions and Answers
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The Medicare Program Eligibility Benefit Period
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No Pay and Benefit Exhaust Bills SNF Denial Information MSP Medicare Secondary Payer Assessments and OMRA’s
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How and When to do a No-Pay Bill Appropriate Codes No-Pay Bill Vs. Demand Bills
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Denial on Admission UR Denials Denial Paragraphs For CMS Denial Letters Go To The CMS site at http://www.cms.hhs.gov/BNI/04_FFSSNFABN andSNFDenialLetters.asp
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MSP Overview When and How to Submit an MSP Claim
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ARD’s and Grace Days OMRA’s Assessment Schedule Assessment Tracker
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Medicare MDS Assessment Type Reason for Assessment (AA8b code) Assessment Reference Date Applicable Medicare Payment Days 5 day01Days 1 – 51 through 14 14 day07Days 11 – 1415 through 30 30 day02Days 21 – 2931 through 60 60 day03Days 50 – 5961 through 90 90 day04Days 80 – 8991 through 100
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What’s Covered To Bundle or Not to Bundle Therapy Caps 59 and KX codes What to do when you’re out of space
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Menu’s Claims Corrections and Adjustments CWF Roster Billing
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Claims-Special OC Codes Return to History Rejected Claims Claim Change Codes
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How to Read the CWF Insurance Codes
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FLU and PPV HCPCS Rates Format
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