Prefix Plan Name D2C Blue Cross Blue Shield of Illinois D2D Anthem BCBS of Indiana D2E Anthem BCBS of Indiana D2L Highmark BCBS of Pennsylvania D2P Highmark BCBS of Pennsylvania D2R Blue Cross Blue Shield of Illinois D2S Horizon Blue Cross Blue Shield of New Jersey D2T Blue Cross Blue Shield of Illinois D2U Horizon … Read more
Plan Identifier Plan Name C8B Blue Cross Blue Shield of Illinois C8C Anthem BCBS of Missouri C8D Anthem BCBS of Missouri C8F Blue Cross Blue Shield of Massachusetts C8M Blue Cross Blue Shield of Illinois C8S Blue Cross Blue Shield of Minnesota C8T Anthem BCBS of Nevada C8V Anthem Blue Cross of California C8W Blue … Read more
Plan Identifier Plan Name B2B Blue Cross Blue Shield of Massachusetts B2C Blue Cross Blue Shield of Texas B2D Regence Blue Shield of Washington B2E Highmark Blue Shield B2F Blue Cross Blue Shield of Texas B2G BCBS of Western New York B2H Blue Cross Blue Shield of Massachusetts B2J Blue Cross Blue Shield of Illinois … Read more
What is Denial Code 22? Denial Code 22 in medical billing refers to “This care may be covered by another payer per coordination of benefits (COB).” This denial occurs when the insurance payer determines that another insurer should be the primary payer, leading to claim rejection or a delay in reimbursement. Common Causes of Denial … Read more
What is Denial Code 29? Denial Code 29 in medical billing indicates “The time limit for filing has expired.” This means that the claim was submitted after the payer’s allowable timeframe for claim submission, resulting in denial. Every insurance payer, including Medicare, Medicaid, and commercial insurers, has a specific timeframe within which claims must be … Read more
What is Place of Service 02 POS 02 stands for Place of Service Code 02, which is used by healthcare providers to show that telehealth services were given somewhere other than the patient’s home. This could be a clinic, hospital, or other medical facility. Key Points: Common in rural or dialysis center settings. It tells … Read more
When billing for outpatient medical services, choosing the correct Place of Service (POS) code can make or break your reimbursement. Among the most debated are POS 2 (Telehealth Provided Other than in Patient’s Home) and POS 10 (Telehealth Provided in Patient’s Home). These two codes may seem similar, but their implications for billing, reimbursement, and … Read more
The HCFA CMS-1500 form is a standardized claim form used by healthcare providers in the United States to bill Medicare and Medicaid programs, as well as many private insurance companies. The form, developed by the Centers for Medicare & Medicaid Services (CMS), is essential for ensuring that healthcare providers receive reimbursement for services rendered to … Read more
A copay is a fixed amount that a patient is required to pay for a specific medical service or prescription, at the time the service is provided. It is denoted as copay (PR-3) This amount is typically predetermined by the patient’s health insurance plan and does not change based on the total cost of the … Read more
Introduction: A deductible is the amount of money a patient has to pay out-of-pocket for covered healthcare services before their health insurance policy starts covering the costs it is also denoted as PR-1. It is a standard feature of most health insurance plans, and it resets annually. Once the deductible is met, the insurer will … Read more
