Payments - Rebilling

jmager wrote on Tuesday, September 06, 2011:

How do I re-open or re-submit a bill to an insurance company after they (insurance company) make a partial payment on an encounter. 

They have paid for only one cpt code but deny payment on the other cpt codes for various reasons.

Do I do it by re-opening the billing and then go to the fee sheet and delete the cpt code they paid for?  That seems like a bad idea!!

Hope some one can help me out.

cverk wrote on Wednesday, September 07, 2011:

I would reopen the claim, fix the problems associated with the unpaid CPT codes such as getting corrected diagnosis codes or adding the correct modifier and rebill the whole claim. It is my experience that insurance company claim software will mark the paid code a duplicate and reprocess the other codes for payment. If whatever caused the original codes to be denied is corrected and is a paid benefit, those codes will be paid seperately. If the error is in using the wrong CPT code, such as the incorrect age range on a preventive care exam, then I have indeed deleted the unpaid code and entered the correct CPT and ICD9 code and rebilled it. Again the payment software will not repay the previously paid codes.

jmager wrote on Wednesday, September 07, 2011:

Thank you for your response!