This course introduces Medicare follow-up processes.
After completing this course, you will understand:
* List courses offered on the CMS website.
* Identify the CMS system, FISS and information available within it.
* Differentiate between an FI and a Carrier.
* Determine when a clean claim will be paid if it is sent electronically or paper.
* List the filing limit.
* Determine if a claim got into the CMS system, FISS, and analyze activity on the account and common suggestions or follow-up, including: working RTP, 72-hour rule, MSP issues, when the Beneficiary information is incorrect, overlapping dates of service, and self-administered drugs.
* Select the appropriate Type of Bill, FL 4, when sending a cancelled claim and an adjustment
* Define an OCE and a CCI edit.
* Determine if a modifier should be added and when.