Attachment Medical necessity Denial NPI SUPPLEMENTAL CLEARINGHOUSE TIMELY FILING Non covered GLOBAL PERIOD APPEAL Coding MEDICARE POS DEDUCTIBLE TECHNICAL COMPONENT Clinic SUBSCRIBER U of R EPIC Spreadsheet NON- PAR ABN COINSURANCE CPT 1500 form E/M PROFESSIONAL COMPONENT Tax ID Referral record Authorization WORKERS COMP MEDICAID GLOBAL COMPONENT Work- Queue's COB COMPLIANT Provider Nurse GUARANTOR REPLACEMENT claim ICD PAR BUNDLED Hospital NON- COMPLIANT OP Note MODIFIER EOB Self- Pay COPAY Productivity Credit balance PCP COMMERCIAL INSURANCE Attachment Medical necessity Denial NPI SUPPLEMENTAL CLEARINGHOUSE TIMELY FILING Non covered GLOBAL PERIOD APPEAL Coding MEDICARE POS DEDUCTIBLE TECHNICAL COMPONENT Clinic SUBSCRIBER U of R EPIC Spreadsheet NON- PAR ABN COINSURANCE CPT 1500 form E/M PROFESSIONAL COMPONENT Tax ID Referral record Authorization WORKERS COMP MEDICAID GLOBAL COMPONENT Work- Queue's COB COMPLIANT Provider Nurse GUARANTOR REPLACEMENT claim ICD PAR BUNDLED Hospital NON- COMPLIANT OP Note MODIFIER EOB Self- Pay COPAY Productivity Credit balance PCP COMMERCIAL INSURANCE
(Print)
Attachment
Medical necessity
Denial
NPI
SUPPLEMENTAL
CLEARINGHOUSE
TIMELY FILING
Non covered
GLOBAL PERIOD
APPEAL
Coding
MEDICARE
POS
DEDUCTIBLE
TECHNICAL COMPONENT
Clinic
SUBSCRIBER
U of R
EPIC
Spreadsheet
NON-PAR
ABN
COINSURANCE
CPT
1500
form
E/M
PROFESSIONAL COMPONENT
Tax ID
Referral record
Authorization
WORKERS COMP
MEDICAID
GLOBAL COMPONENT
Work-Queue's
COB
COMPLIANT
Provider
Nurse
GUARANTOR
REPLACEMENT claim
ICD
PAR
BUNDLED
Hospital
NON-COMPLIANT
OP Note
MODIFIER
EOB
Self-Pay
COPAY
Productivity
Credit balance
PCP
COMMERCIAL INSURANCE
