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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
Anatomical Modifiers
This is about anatomical modifiers.
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50
anatomical modifiers
both left and right
left
LT
modifier
modifiers
parts
right
RT
NON-COVERED CHARGES
This document is about denials when the insurance does not cover the procedures.
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130
204
denial
N130
non covered
non covered charges
non-covered
non-covered charges
PR204
procedure not covered
LAPSE IN COVERAGE and COVERAGE TERMINATED
This document is about the denials: lapse in coverage and coverage terminated.
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CO27
coverage termed
coveraged terminated
denial
lapse in coverage
PR200
PR27
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