Maintenance of Benefit COB Visit Maximum HB255 Office Modifier 26 Over Maximum Bilaterial Procedure Physician Charge OPL Department Medicare Member Liability DX Codes DME Medicare Fee Schedule Authorization Timely Filing Participating Providers UB04 BlueCard Technical Component Reimbursement Major Medical Clean Claims Act TOS Copay E&M Codes Deductible LLP Panic Disorder Submission Format MD & DC Plan Allowance Percentage Discounts Northern VA and DC BlueShield General Reimbursement Out of Pocket CMS- 1500 Out of Network Code Set Medigap RT/LT Type of Bill CPT Emergency Room Visit HCPCS Maintenance of Benefit COB Visit Maximum HB255 Office Modifier 26 Over Maximum Bilaterial Procedure Physician Charge OPL Department Medicare Member Liability DX Codes DME Medicare Fee Schedule Authorization Timely Filing Participating Providers UB04 BlueCard Technical Component Reimbursement Major Medical Clean Claims Act TOS Copay E&M Codes Deductible LLP Panic Disorder Submission Format MD & DC Plan Allowance Percentage Discounts Northern VA and DC BlueShield General Reimbursement Out of Pocket CMS- 1500 Out of Network Code Set Medigap RT/LT Type of Bill CPT Emergency Room Visit HCPCS
(Print)
Maintenance of Benefit
COB
Visit Maximum
HB255
Office Modifier 26
Over Maximum
Bilaterial Procedure
Physician Charge
OPL Department
Medicare
Member Liability
DX Codes
DME
Medicare Fee Schedule
Authorization
Timely Filing
Participating Providers
UB04
BlueCard
Technical Component
Reimbursement
Major Medical
Clean Claims Act
TOS
Copay
E&M Codes
Deductible
LLP
Panic Disorder
Submission Format
MD & DC
Plan Allowance
Percentage Discounts
Northern VA and DC
BlueShield
General Reimbursement
Out of Pocket
CMS-1500
Out of Network
Code Set
Medigap
RT/LT
Type of Bill
CPT
Emergency Room Visit
HCPCS
