The DCN number is located on the remittance advice. This number must be used with adjustment/cancellation bills.
.
CLAIMS PROCESSING
A brief description of claims processing methods follows. All paper submitted claims are assigned a unique Document Control Number (DCN). The DCN identifies and tracks claims as they move through the claims processing system. This number contains the Julian date, which indicates the date the claim was received. It monitors timely submission of a claim.
Document Control Numbers are composed of 11 digits:
2-digit plan year
3-digit Julian date
2-digit BCBSTX reel identification
4-digit sequential number
Claims entering the system are processed on a line-by-line basis except for inpatient claims. Inpatient claims are processed on a whole-claim basis. Each claim is subjected to a comprehensive series of checkpoints called edits. These edits verify and validate all claim information to determine if the claim should be paid, denied or pended for manual review.
You are responsible for all claims submitted with your Provider number, regardless of who completed the claim. If you use a billing service you must help ensure that your claims are submitted properly.
Note: Entities submitting claims for services rendered by a Healthcare Provider are subject to Texas HHSC suspension if they submit claims for a Provider who is suspended from HHSC.
Medicare Payments, Reimbursement, Billing Guidelines, Fees Schedules , Eligibility, Deductibles, Allowable, Procedure Codes , Phone Number, Denial, Address, Medicare Appeal, EOB, ICD, Appeal.
Medicare Guideline posts
- Home
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation process - how often provide need to do - FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
Subscribe to:
Post Comments (Atom)
Top Medicare billing tips
-
Patient Discharge Status Code - Definition A patient discharge status code is a two-digit code that identifies where the patient is at th...
-
CPT CODES and Description 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitr...
-
REIMBURSEMENT GUIDELINES Global Obstetrical (OB) Care As defined by the American Medical Association (AMA), "the total obstetric pa...
-
procedure code and description 93922 LIMITED BILATERAL NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, (EG, FOR LOW...
-
CPT CODE J3301 - Kenalog-40 Injection Kenalog-40 Injection (triamcinolone acetonide injectable suspension, USP) is a synthetic glucocortic...
-
Procedure code and description 95806 - Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory air...
-
Procedure code and Description 99050 Services provided in the office at times other than regularly scheduled office hours, or days when the...
-
Frequency Limitations: Testing may be covered up to two times a year in clinically stable patients; more frequent testing may be reasonabl...
-
procedure code and description 11042 -Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 square cm ...
-
Procedure Code Changes and Description • Deleted Codes * 49080 - Peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic...
No comments:
Post a Comment