Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page

Practice Exam

2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Tag Archives: Insurance

5 Trends Shaping the Health Insurance Market

Posted on by

What does the cost of rising health insurance mean for you? By Wendy Dressler Image via Pexels There are a lot of changes coming to the world of healthcare and health insurance. It’s no secret that the cost of health coverage is rising, and this has led to one of the most profitable years for […]

The post 5 Trends Shaping the Health Insurance Market appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Workers comp or health insurance

Posted on by
I am working on an appeal for a patient. Here is a little background, patient fell and hurt his back at work, went to get checked out and they asked about abnormal movements. He was referred to a specialist where he was diagnosed with Huntington’s disease. He now comes to my office for treatment of the disease. I have billed his insurance but they are not paying for the visits due to it being related to workers comp. Should this be billed to workers comp or should I continue with the appeal?

Medical Billing and Coding Forum

Substance TX and Private Insurance Billing

Posted on by
I bill for a group practice that is fairly new to private insurance. Our main payer is state medicaid. I am having a hard time trying to get info on how to bill private insurances when services are rendered under a certified addiction counselor…the state of Maryland acknowledges CAC’s but most private insurances don’t credential them but they do credential the LCSW’s or LCPC’s who are the supervising providers of each location. Cigna doesn’t recognize supervising and I know this isn’t the same as "incident to" billing as that is only in a physician setting. I bill on CMS 1500 and trying to figure this out. In most of our offices the CAC or CSC holds the assessments OP or IOP groups for substance tx, how is this billed under private insurances? Any help or hindsight would be greatly appreciated.

Medical Billing and Coding Forum

CPT 91035 is not being paid by the majority of the insurance companies- Why?

Posted on by
CPT 91035 is not being paid by the majority of the insurance companies. We need to find out how to get this CPT code paid. Do we need to add a modifier, obtain additional prior auths? This is usually billed with CPT 43235. Even when its billed by itself it is being denied. Anyone knows what happen here?

Medical Billing and Coding Forum

CPT 91035 is not being paid by the majority of the insurance companies- Why?

Posted on by
CPT 91035 is not being paid by the majority of the insurance companies. We need to find out how to get this CPT code paid. Do we need to add a modifier, obtain additional prior auths? This is usually billed with CPT 43235. Even when its billed by itself it is being denied. Anyone knows what happen here?

Medical Billing and Coding Forum

Lowering patient balances after insurance

Posted on by
Hi, I am looking for some information on changing the patient balance to a smaller amount after we bill insurance. I have a provider that only wants to charge all office visits after insurance a certain amount. That usually means I have to give the patient more of a discount after their insurance has been billed. I am wondering if this is legal to do.

Medical Billing and Coding Forum

Timely filing when patient DID NOT update insurance

Posted on by
Howdy :)

A patient was originally seen about a year ago and provided no insurance information. They made a couple small payments on the 2 bills over the course of a year. Then, they called almost a full year after originally seen and, "Oh! Here’s my insurance – bill it, please!"

Ugh.

So we did. And they denied it as being wellllllllll past timely. (I’ll give you a minute to get over your shock.)

So… can we bill the patient for this because they DID NOT give us that info timely and we can back that up if need be?

We’re having a differing of opinions here. If you say we can, please provide a link to some sort of reference for this.

Thanks! :)

Medical Billing and Coding Forum

Billing insurance for pre-op and post-op visits for a cash pay surgery

Posted on by
One of my providers posed this question.

A pt has a surgery done and must pay cash (for denial, elective surgery, etc.). Other specialists practices are telling us they are still billing the pt’s insurance for the pre-op and post-op visits. (Even those w/in the global period). He asked if it would be "correct" to bill this way.

I told my provider that I was uncomfortable doing this, because even though the pt paid cash, I feel it is still a global charge and I am also afraid that if we were audited we would get cited for not billing equally to all of our patients.

Thoughts?

Medical Billing and Coding Forum