Novitas Medicare Part B, the Medicare JL contractor for providers in the District of Columbia, Delaware, Maryland, New Jersey and Pennsylvania posted the most common reasons for Part B claim submission errors for September 2016. Some key reasons and how GIRS assists our clients’ accounts to avoid these errors are presented below:
- Non-covered charges.
- Duplicate claim service
- The benefit for this service is included in the payment or allowance for another service or procedure that has already been adjudicated
- Payment is denied when performed/billed by this type of provider
- Claim not covered by this payer/contractor
- The procedure code is inconsistent with the modifier used or a required modifier is missing
The GIRS InContact Reimbursement Line™ develops Billing Guides and Coding verifications are conducted to verify codes and modifiers with payers. The InContact Reimbursement Line™ also assists accounts to conduct benefit verifications to identify the patients benefits prior to service provision, the specific payer requirements for the claims submission and the coverage and payment of the services. Providers are guided to contact the payer and verify fees and coverage when necessary.
If your accounts are experiencing denials of coverage or experiencing claims submission issues, please Click Here to Contact Us for further information.