Following Up on a Medicare Payment
This course introduces Medicare follow-up processes.
- List courses offered on the CMS website.
- Identify the CMS system, FISS and information available within it
- Differentiate between an FI and a Carrier.
- Determine when a clean claim will be paid if it is sent electronically or paper.
- List the filing limit.
- Determine if a claim got into the CMS system, FISS, and analyze activity on the account and common suggestions or follow-up, including: working RTP, 72-hour rule, MSP issues, when the Beneficiary information is incorrect, overlapping dates of service, and self-administered drugs.
- Select the appropriate Type of Bill, FL 4, when sending a cancelled claim and an adjustment
- Define an OCE and a CCI edit.
- Determine if a modifier should be added and when.