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Introduction to Denials
This describes further what denials are.
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CARC
denial
denials
EOB
ERA
RARC
reason
reason code
remark
remark code
Payment Posting and EOB
This shows what happens during payment posting and explains what EOB / ERA is.
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CARC
denial
denials
electronic remittance advance
EOB
ERA
explanation of benefits
payment posting
payments
RARC
reason
reason code
reason codes
remark
remark code
remark codes
Philippine vs US Healthcare System
This document shows the comparison between the healthcare system of the Philippines and the US.
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Healthcare
Healthcare system
Medicaid
Medicare
PhilHealth
Philippines
United States
US
Patient Form / Patient Demographics Quality Control
This document shows how to check each part of the patient demographics.
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checking
demo
patient demographics
patient form
quality assurance
Quality Control
Fee-For-Service (FFS) vs Capitation
These are the two different modes of payment of how providers are paid.
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capitation
fee for service
fee-for-service
FFS
HMO
payment
PPO
Hospice
This teaches when to apply modifiers for procedures on hospice patients.
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hospice
Medicare
modifier GV
modifier GW
Distinct Procedures
This is about learning how to separate surgical procedures from one another using modifier.
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distinct procedure
Modifier 51
Modifier 59
separate procedure
Repeat Procedures
This is about procedures being repeated and how to properly charge them to avoid denials.
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different provider
modifier 76
modifier 77
repeat procedure
same day
same provider
Professional and Technical Component
This is about the professional and technical components of some procedures.
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equipment
modifier 26
modifier TC
professional component
reading
technical component
Global Period and Evaluation & Management
This is about office visits and the global period of surgical procedures.
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0-day
10-day
90-day
E & M
evaluation and management
global period
modifier 24
modifier 25
office visit
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