12 – Working Aged Beneficiary or Spouse with Employer Group Health Plan 13 – End-Stage Renal Disease Beneficiary in the 30-Month Coordination Period with an Employer’s Group Health Plan 14 – No-fault insurance, including auto, is primary (any no-fault insurance) 15 – Workers’ Compensation … Read more
1) These are the Medicare programs established to help low-income beneficiaries where Medicaid pays their Medicare Part A & Part B premium, Medicare coinsurance, and Medicare Deductible. 2) Below are the Medicare programs and their covered benefit, 3) You will find a scenario where a claim was paid by Medicare as primary and Medicaid denied … Read more
1) CLIA Waived Test 2) CLIA Non-Waived Test
CPT codes are classified into 3 categories: I) Category I – This is the main category of CPT that used by providers to represent their different services and reimburse the payment. Below are the 6 different sections of this category with specialties and CPT range, 1. Anesthesia Services: 00100 – 01999 & 99100 – 991502. Surgery: 10004 – 699903. Radiology … Read more
Prefix Plan Name Provider Phone Number Z2M Blue Cross Blue Shield of Rhode Island Z3A Blue Cross Blue Shield of Illinois Z3F Blue Cross Blue Shield of Illinois Z3G Blue Cross Blue Shield of Illinois Z3K Blue Cross Blue Shield of Illinois Z3M Blue Cross Blue Shield of Rhode Island Z3N Blue Cross Blue Shield … Read more
Prefix Plan Name Phone Number Y2A Blue Cross Blue Shield of Illinois Y2M Blue Cross Blue Shield of Nebraska YAA Anthem BCBS of Connecticut YAB Regence Blue Cross Blue Shield of Oregon YAC Anthem BCBS of Kentucky YAD Blue Cross Blue Shield of Rhode Island YAE Anthem BCBS of Virginia YAF Anthem BCBS of Colorado … Read more
Plan Identifier Plan Name X2A Anthem BCBS of Connecticut X2B Blue Cross of Idaho X2C Anthem BCBS of Connecticut X2D Anthem BCBS of Connecticut X2E Anthem BCBS of Connecticut X2H Wellmark BCBS X2P Anthem BCBS of Virginia X3A Anthem BCBS of New Hampshire X3H Wellmark BCBS X9A Blue Cross of California XAA BCBS of Alabama … Read more
Prefix Plan Name W2A Blue Shield of Northeastern New York W2B Blue Cross Blue Shield of Illinois W2C Anthem BCBS of Georgia W2E Anthem BCBS of Colorado W2F Blue Cross Blue Shield of Illinois W2G Regence Blue Cross Blue Shield of Oregon W2I Anthem BCBS of Virginia W2K Blue Cross Blue Shield of Arkansas W2L … Read more
