We will often ask you for additional information to get your claims paid, or we need information that was left off the original Superbill when it came over to us.
You can help us tremendously by making sure your staff is responding quickly to these requests. If they are on our "info needed" list, these claims are just sitting, and we really want to get them out the door.
What are some common items we are missing:
Cpt code
DX code
Modifier - RT or LT or toe digit etc.
DLS (Date last seen)
PCP (Goes with DLS, we need the Primary Care Physician)
Medical notes - this means the insurance is asking us to jump through some hoops to get you paid, for an appeal etc.
Patient Demographics - we only ask if we don't have them already.
Patient's insurance - We do not know where to send the claim until we get this information. (Be sure and ask for updated insurance information each time you see a patient. This really helps us.)
I would say on all Humana claims just send us the notes with the claim. They are going to deny one procedure each time if you have two or more that you are billing. We must send in notes every time to get Humana to pay the CPT they bundle. (It has been like that since 2014, and we have made numerous calls about this, to no avail. We just really need your notes in a timely fashion to get these paid in full.)
It is very important that we get patient payments, paper remits that come in the mail to your office and charges to bill, in a timely manner. We work like a well-oiled machine when these things are sent to us regularly. If we are not getting these, however, its slows down the whole process and we want to make sure we stay on top of everything for you!
Thank you for helping us stay on top of these issues so we can get you paid.
