Sending multiple procedures under one claim

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drmiller34
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Joined: Thu Sep 22, 2016 9:40 pm

Sending multiple procedures under one claim

Post by drmiller34 » Mon Jan 09, 2017 4:28 pm

The problem I am having is that when medisoft V20 sends out a claim to RelayHealth for a particular date of service it is separating the claim into multiple individual claims i.e. One date of service with for instance 3 procedure codes are coming back from all the insurers listed as three separate claims instead being listed on one EOB under one date of service with however many procedures/E&M codes for that date. It is making keeping pt accounts correct difficult as sometimes the full amount for one date of service is coming in on separate EOB/Checks and even in some instances the checks are arriving days apart. Is there a way to fix this?

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Gavin Walker
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Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
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Re: Sending multiple procedures under one claim

Post by Gavin Walker » Tue Jan 10, 2017 11:42 am

One possible reason for this is because you are entering a different list of diagnosis codes for each charge line on the claim. To correct this, enter the EXACT same list of diagnosis codes in the exact same order for diagnosis codes 1 through 12 on each charge line. So, if some diagnosis codes do not apply to all procedure codes, list them on each procedure code anyway in the exact same order. Then, to specify which diagnosis codes apply to each procedure, check up to 4 diagnosis pointers for each charge line.
Gavin Walker
Walker Tek Solutions, LLC
866-890-6777
417-890-6777

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