Medical Coding Jobs and Career

Duplicate Denial Reason - [ Denial Code - CO-18 ] Duplicate denial reason, if same claim filed twice or more times for same date of service then initial claim will be processed and other claims will be denied as duplicate. If claim filed twice then we need to follow up on initial claim need to verify initial claim status from insurance representative or web portal. If claim filed once and denied as duplicate then contact insurance representative and request for reprocess of the claim as claim was submitted only once now next reason for a duplicate denial.  If two services are rendered on same date of service and claim not filed with appropriate modifier then claim may deny as duplicate in this case we need to append appropriate modifier and submit corrected claim additional points.     If patient demographic changes made on claim we need to submit fresh claim if any coding Corrections made unclaimed need to submit corrected claim with resubmission code 7 and ...

Denial Reason Code C029 – Timely Filing Limit Exceeded Denial Reason Code C029 - Timely Filing let us understand the denial reason most of the insurance will set a specific timely filing limit to submit a claim. If claim is filed after timely filing limit it will be denied stating timely filing limit has been expired.  If claims timely filing limit is 180 days from date of service then claims must be submitted within that timely filing limit.  Timely filing limit varies from insurance to insurance, and it also depends on a provider contract. [ For  Example ] As we know medicare claims timely filing limit is one year from date of service we will take the example of a medicare payer here our date of service is a january 1st of 2020 and claims timely filing ends on december 31st of 2020. claim was initially filed to medicare on january 1st of 2021 and it was received by payer on january 2nd of 2021 that is after one year from date of service so here medicare wil...

Deductible Coinsurance Copay Deductible CoInsurance Copay what is patience out-of-pocket patients? Expenses for medical care that are not reimbursed or paid by payer are called out-of-pocket. These expenses are patient responsibilities apart from insurance premiums out-of-pocket includes deductible co-payment.   1. Deductible:  It is fixed amount that patient agrees to pay as per contract of policy before insurance begins to pay to provider   [   For example  ]  if patients deductible is $1,000 as per policy contract patient need to pay all medical bills until it reaches thousand dollars these thousand dollars our patient responsibilities apart from insurance premium after deductible is met insurance covers medical charges partially. 2. Coinsurance:  It is applied towards patient responsibility as per patients contract Coinsurance it is the percentage amount of medical expenses that patient shares with the insur...