Important : BCBS New id format

All of the BCBS plans have been posting announcements about the new alpha/numeric prefixes that they’re going to be rolling out next year. Below is the announcement that Anthem put in a recent newsletter:

New member ID prefixes coming in 2018 The Blue Cross and Blue Shield Association (BCBSA) assigns member ID prefixes for all Blue Cross and Blue Shield branded Plans – Anthem Plans as well as non-Anthem Plans. There are a limited number of unused three-character, alpha only prefixes remaining, and they are expected to be exhausted in the 2nd or 3rd quarter of 2018. When that happens, the BCBSA will begin assigning prefixes that contain a combination of letters and numbers, or alpha-numeric prefixes.

What does this mean to you?

It will be even more important to ask your patients for their most recent identification (ID) card.When submitting claims, enter the identification number exactly as it appears on the member’s ID card.Check your EDI Software to make sure it can accept alpha-numeric prefixes.Check any internal documents you may have and update any references of “alpha prefix” to “prefix”.

Note: Current three-character, alpha-only prefixes will not be affected by this change. Current prefixes will still be valid once the new alpha-numeric prefixes are issued, unless there is another need to change or remove a prefix currently in use.

Comments

What is QMB / MQMB stands for?

In Medical billing or Healthcare industry The term QMB stands for Qualified Medicare Beneficiary & MQMB stands for Medicare Qualified Medicare Beneficiary. The term "QMB" or "MQMB" on the form indicates the client is a Qualified Medicare Beneficiary (QMB) or a Medicaid Qualified Medicare Beneficiary (MQMB). The Medicare Catastrophic Coverage Act of 1988 requires Medicare premiums, deductibles, and coinsurance payments to be paid for individuals who meet the following criteria: Important: Clients limited to QMB are not eligible for THSteps or THSteps-CCP Medicaid benefits. Note: Clients eligible for STAR+PLUS who have Medicare and Medicaid are MQMBs. Medicaid reimburses for the coinsurance and deductibles as well as Medicaid-only services for the MQMB client. QMBs do not receive Medicaid benefits other than Medicare deductible and coinsurance liabilities. MQMBs do qualify for Medicaid benefits not covered by Medicare in addition

Rejection Procedure note qualifier is missing

Need to check the Charges tab and double click on the Procedure Code line to open up the Charge Entry window. There is a Notes section on the right hand side. If there is a note typed, we need to select the type. Need to select field and select the appropriate type of note you are sending. Save the changes made Check all the procedure if submitted many procedure. Save the visit again and submit the claim.

Mastering the 'Tell Me About Yourself' Interview Question: Best Tips and Examples

In a job interview, the "Tell me about yourself" question is often asked early on and is an opportunity to make a positive first impression. The key is to provide a comprehensive response that highlights your qualifications and aligns with the job you're applying for. Here's a structured approach to crafting the best answer: Start with a Brief Personal Introduction: Begin by mentioning your name and your current or most recent role, if applicable. For example, "I'm [Your Name], and I'm currently working as a Sr AR Specialist at XYZ Company." Provide a Summary of Your Professional Background: Offer a concise overview of your professional journey, emphasizing the experiences and skills most relevant to the position you're interviewing for. You can mention your years of experience, notable career achievements, and areas of expertise. Highlight Relevant Achievements: Share specific accomplishmen

Medical Billing

Search This Blog