Customer service representatives cannot provide claim status via the toll-free service line
Medicare guidelines, specifically, the Internet-only manual (IOM) Publication, 100-09 Chapter 6 Section 50.1 requires that providers call the interactive voice response system (IVR) to obtain claim status. Service associates responding to calls via our toll-free service line are not allowed to provide claim status. To do so
would be in violation of Medicare service guidelines.
First Coast Service Options’ (First Coast’s) customer service representatives (CSRs) continue to receive a large volume of calls from providers asking for claim status. In the majority of cases the calls are coming from entities representing Medicare providers. Because many providers have chosen to outsource their claims monitoring activities, they may not be aware that the entities representing them are calling the toll-free CSR service line for status of claims instead of using the IVR.
When claim status calls are made to the toll-free CSR service line, it slows our response time for other calls coming into our call center because service associates are attempting to explain to customers that status cannot be released via the general inquiry service line. It is the responsibility of Medicare providers to notify the entities representing them that claim status inquiries must be made via the IVR or our new Internet portal the SPOT. See http://medicare.fcso.com/Landing/256747.asp.
Learn Medical Billing Process, Tips to best AR Specialist. Medical Insurance Billing codes, Denial, procedure code and ICD 10, coverage guidelines. Demographic, charge, payment entry, AR process and eligibility and follow up. How to Guide.
Pages
- Home
- Medical Billing Question and Answer - Terms
- Insurance Denial Claim Appeal Guidelines.
- Medical Billing Downloads
- Understand Medical Billing
- Medical Billing Outsource
- Medicare Coverage and Plan Overview
- Advertise with us
- EVALUATION AND MANAGEMENT CPT code [99201-99499] - Full List
- Overall Medical billing process
- CPT Code 99201, 99202, 99203, 99204, 99205 - Which code to USE
- Internal Medical Billing Audit - how to do

Dont call Medicare toll free service line for claim status
Subscribe to:
Post Comments (Atom)
Medical Billing Popular Articles
-
CPT CODE AND Description 99391 - Periodic comprehensive preventive medicine reevaluation and management of an individual including an age...
-
Procedure CODES and Descriptions 99401 - Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an indi...
-
CPT Code and description 99381 - Initial comprehensive preventive medicine evaluation and management of an individual including an age an...
-
Procedure code and Description 99251 Inpatient consultation for a new or established patient, which requires these 3 key components: A pro...
-
CPT code and description 80050 - General health panel This panel must include the following: Comprehensive metabolic panel (80053), ...
-
93000-93010: Hone Your ECG Coding Skills With 3 Essential Pointers Whether you call them ECGs or EKGs, chances are you see a lot of elec...
-
Billed amount: It is the Amount charged for each service performed by the provider. In other words it is the total charge value of the cla...
-
When an ERA is received, providers may: •Post decision and payment information automatically, for individual claims included in an R...
-
Background: Type of Service (TOS) is an indicator that the contractor places on the Form CMS-1500 paper form or electronic format. The indic...
-
Medicare denial code and Descripiton 1 Deductible Amount 2 Coinsurance Amount 3 Co-payment Amount 4 The procedure code is inconsistent ...

No comments:
Post a Comment