ADVANCE NOTICE OF EXCESS CLAIM REPORT
|
|
|
- Georgiana Moore
- 8 years ago
- Views:
Transcription
1 ADVANCE NOTICE OF EXCESS CLAIM REPORT Please provide the following information for claimants that 15,000 or more is expected to be paid on. Group Name: Pooling Point: Effective Date: Claimant Information Employee Name: DOB: Effective Date: Claimant Name: DOB: Effective Date: Relationship: ME FE MSP FSP MC FC Diagnosis: (Please include ICD9 codes) Amount paid to date: Amount Pending: Reason pending: ***Please contact us if you have large hospital bills, or high dollar RX, or treatments to obtain additional discounts *** Estimate of additional charges: Initial date of treatment: If treatment ongoing, if yes please estimate additional charges: Current Treatment and Prognosis: Please specify if LCM is currently in place: Y or N If yes, please list contact, and phone: If no please specify reason: TPA Name: Address: (Please note this is where reimbursements will be sent) Phone: Submitted By: PLEASE SUBMIT CLAIMS TO: Claims@umexperts.com Date: (267)
2 Bank Account Information for ACH Transfers Please fill out the following information so we can transfer fund requests. Group Name: Effective Date: Bank Account Number: Bank Account Name: ABA Number: Bank Name: Bank Address: Please send to: (267)
3 Dear Third Party Administrators: Please find all the forms required for filing Specific, Aggregate, Aggregate Only or Maximum Advantage claims for. Our phone Directory with contact information. A list of Potential High Dollar or Catastrophic Diagnosis Codes. A 50% Advance Notification. o Also be used to notify of Catastrophic Diagnosis. An Initial Specific Excess Claim Reimbursement Request. (N/A) A Supplemental Specific Excess Claim Reimbursement. (N/A) A Specific Claim Eligibility/Work Status. (N/A) Maximum Advantage/Aggregate Only Tracking Form An Aggregate Excess Insurance Claims Report o This should be submitted on a monthly basis separated by the number of tiers, as specified on the contract terms. Should you have any questions regarding the completion of these forms, please call us at Thank you, Rebecca Landis Chief Claims Officer Underwriting Management Services
4 Documentation Requested for Maximum Advantage Fund Request(s) When submitting a funding request please include the following: Tracking form Request form Check registers For first request these should total the paid claims reported If a supplemental requests this should be from last request to current A pending report this should show total claims that when added to the check registers will match the total claims less any adjustments, out of contract payments, voids or refunds. Also note current monthly premium must be received by UME, and funding in claims account needs to be accounted for. If we do not agree for any reason or payment will be different than requested a written explanation will be sent. Please send this together to the following address: Claims@umexperts.com
5 Corresponding ICD9 Code List Infectious and Parasitic Diseases Pneumonia Septicemia Chronic Obstructive Pulmonary Disease (COPD) 042 Aids/HIV 515 Postinflammatory Pulmonary Fibrosis Viral Hepatitis Pulmonary Collapse and/or Respiratory Failure Neoplasms Disease of the Digestive System Malignant Neoplasms of lip, major Salivary Glands, Gum, Mouth,Pharnyx Regional Enteritis (Chron's Disease) Mal Neo Of Esophagus Intestinal Obstruction Mal Neo of Stomach 562 Diverticulitis of Colon Mal Neo of Colon Peritonitis Mal Neo of Rectum Other Disorders of Intestine Mal Neo of Liver Liver Diseases and Cirrhosis Mal Neo of Pancreas 572 Other Sequela of Chronic Liver Disease Mal Neo of Larnyx Other Liver Disorders Mal Neo of Lung Pancrease Diseases Mal Neo of Bone Gastrointestinal Hemorrhage Mal Neo of Female Breast Mal Neo of Uterus or Cervix Diseases of the Genitourinary System Mal Neo of Ovary Acute Renal Failure 185 Mal Neo of Prostate 585 Chronic Renal Failure Mal Neo of Testis 586 Renal Failure, Unspecified Mal Neo of Brain 588 Disorders Resulting from Impaired Renal Function Mal Neo of Bladder, Kidney, Urinary 592 Calculus of Kidney & Ureter Mal Neo of Nervous System Mal Neo of Endocrine Glands Complications of Pregnancy, Childbirth Mal Neo of Oth. IllDefined Sites 641 Placenta Previa Secondary Mal Neo Lymph Nodes Eclampsia, Pre Eclampsia Secondary Mal NeoResp & Digestive Systems Premature Labor Secondary Mal Neo Oth Spec Sites 648 Gestational Diabetes Lymphoma and/or Leukemia 651 Multiple Gestation 235 Neoplasm of Uncertain Behavior 654 Abnormality of Organs and Soft Tissue, of Pelvis Neoplasm of Uncertain NatureBone, Skin Diseases of the Respiratory System Diseases of the Musculoskeletal System and Connective Tissue Endocrine, Nutritional, Metabolic, Immunity Osteoartrhosis Diabetes 721 Lumbosacrel Spondylosis 277 Cystic Fibrosis Intervertibral Disc Disorders 278 Obesity/Hyperliment Osteomyelitis and/or Periostitis 737 Kyphoscoliosis and Scoliosis Diseases of the Blood and BloodForming Organs SickleCell Anemia Congenital Anomalies Aplastic Anemia NOS 747 Aortic Atresia/Stenosis Coagulation Defects and/or Hemophilia 751 Bilary Atresia Other and Unspecified Congenital Anomalies Diseases of the Nervous System and Sense Organs 330 Cerebral Degenerations Conditions Originating in the Perinatal Period Quadriplegia and Quadriparesis 765 Prematurity Reye's Syndrome 769 Respiratory Distress Syndrome Paraplegia Other Respiratory Conditions in Newborn Encephalopathy Neuropathy/Mysathenia Gravis Symptoms, Signs, and IllDefined Conditions Symptoms Involving Cardiovascular System Chest Pain Diseases of the Circulatory System Acute Myocardia Infarction Injury and Poisoning Acute and Subacute Ischemic Heart Disease Fracture of Skull Coronary Atherosclerosis (ASHD) Fracture of Vertibral Column Acute Pulmonary Heart Disease Fracture of Vertibral Column with Spinal Cord Inury Chronic Pulmonary Heart Disease 828 Multiple Fractures 417 Aneurysm of Pulmonary Artery Intracranial injury Acute and Subacute Endocarditis 869 Internal Injury Valve Disorder 887 Traumatic Amputation of Arm and Hand Cardiomyopathy 897 Tramatic Amputation of Leg Conduction Disorders Burns Cardiac Dysrhythmias Spinal Cord Injury Heart Failure Complications Peculiar to Certain Specified Conditions Subarachnoid/Intracerebral Hemorrhage Occlusion of Cerebral Arteries V23 Supervision of High Risk Pregnancy 436 Acute Cerebrovascular Accident (CVA) V42V58.9 Transplants Atherosclerosis/ Aortic Aneurysm
6 Maximum Advantage Tracking Form Factors EE ES EC Family Date Group Monthly Funding EE ES EC Fam Actual Funding Needed Medical Claims Paid and Processed RX Claims Paid and processed Total Claims Paid Less Any Voids Refunds or OOC Less UME Previous Reimbursements Claims Fund Balance Comments Instructions on how to fill out form: Input sold factors in cells c2c5, this sheet has precalculations populated. And formulas will carry all the way through worksheet. Please include claims awaiting funding that have been processed in Medical and RX to reflect total (paid/pending) claims. Please submit form monthly whether funds are being requested or not for reporting purposes to:
7 Lisa Schneider Principal Robert Glorioso Executive Assistant Amy Clark Director of Operations Samantha Gallagher Chief Underwriting Officer Keith Peterson Senior VP of Underwriting Kim Schmidt Senior VP of Underwriting Megan Barnes Underwriter Kathryn Lesoken Underwriter Michelle Golembiewski UW Coordinator Shannon Monaco UW Coordinator Donna Yaun Comptroller Christine Derstine Director of Compliance Rebecca Landis Chief Claims Officer Niambi Burton Senior VP of Claims Kim Derstine Claims Auditor UNDERWRITING MANAGEMENT EXPERTS 642 COWPATH RD #196 LANSDALE, PA WEB: (We are working on the website now and anticipate its launch within 3 weeks)
ADVANCE NOTICE OF EXCESS CLAIM REPORT
ADVANCE NOTICE OF EXCESS CLAIM REPORT Please provide the following information for excess claims which have paid at 15,000 or more. Group Name: Effective Date: Claimant Information Employee Name: DOB:
All notifications, trigger diagnosis, LCM reports, pre certification reports, etc. should be sent to: notifications@ihcrisksolutions.
Dear Business Partner: Please take a few minutes to review the contents of our Claims Kit. It provides key instructions for identifying and reporting specific and aggregate claim information to IHC Risk
Description Code Recommendation Description Code. All natural death 001-799 IPH All natural death A00-R99
Natural death Description Code Recommendation Description Code All natural death 001-799 IPH All natural death A00-R99 Infectious and parasitic diseases 001-139 CDC, EUROSTAT, CBS & VG Infectious and parasitic
CCS Statewide CY2012 Fee for Service Expenditures by Claim Type and Diagnosis Duplicate CIN Count Claim Type Code Desc DX Group DX SubGroup Sum of
CCS Statewide CY2012 Fee for Service Expenditures by Claim Type and Diagnosis Duplicate CIN Count Claim Type Code Desc DX Group DX SubGroup Sum of Medi-Cal Reimbursement * Outpatient Supplementary V Codes
ODM Care Management Excel File and Submission Specifications
ODM Care Management Excel File and Submission Specifications Issued: September 2013 1 Table of Contents 1. Introduction...3 2. HIPAA Security Measures...3 3. Care Management Certification Form.....3 4.
2009 Emergency Department
2009 Emergency Department Hospital Utilization Report Prepared by Vermont Department of Health Vermont Department of Banking, Insurance, Securities and Health Care Administration 2009 Vermont Emergency
Certified Clinical Documentation Specialist Examination Content Outline - 2016
Certified Clinical Documentation Specialist Examination Content Outline - 2016 1. Healthcare Regulations, Reimbursement, and Documentation Requirements Related to the Inpatient Prospective Payment System
Using the ICD-10-CM. The Alphabetic Index helps you determine which section to refer to in the Tabular List. It does not always provide the full code.
Using the ICD-10-CM Selecting the Correct Code To determine the correct International Classification of Diseases, 10 Edition, Clinical Modification (ICD-10-CM) code, follow these two steps: Step 1: Look
Critical Illness with Term Assurance
AIG Life Critical Illness with Term Assurance Our comprehensive Critical Illness with Term Assurance delivers more value and quality to the customer and their family than ever before. It is designed to
Chapter I Overview Chapter Contents
Chapter I Overview Chapter Contents Table Number Contents I-1 Estimated New Cancer Cases and Deaths for 2005 I-2 53-Year Trends in US Cancer Death Rates I-3 Summary of Changes in Cancer Incidence and Mortality
The Top 20 ICD-10 Documentation Issues That Cause DRG Changes
7th Annual Association for Clinical Documentation Improvement Specialists Conference The Top 20 ICD-10 Documentation Issues That Cause DRG Changes Donna Smith, RHIA Project Manager, Consulting Services
Non-covered ICD-10-CM Codes for All Lab NCDs
Non-covered ICD-10-CM s for All Lab NCDs This section lists codes that are never covered by Medicare for a diagnostic lab testing service. If a code from this section is given as the reason for the test,
PHC4 35 Diseases, Procedures, and Medical Conditions for which Laboratory Data is Required Effective 10/1/2015
PHC4 35 Diseases, Procedures, and Medical Conditions for which Laboratory Data is Required Effective 10/1/2015 Laboratory data is to be submitted for discharges in the following conditions: 1. Heart Attack
One (1) single qualifying condition of either HIV/AIDS or a Serious Mental Illness (SMI)
Eligibility Criteria for Health Home Services: Chronic Conditions New York State s Health Home eligibility criteria is as follows: Medicaid eligible/active Medicaid; and Two (2) or more chronic conditions;
Limited Pay Policy (L-222B) - Underwriting Guidelines
Limited Pay Policy (L-222B) - Underwriting Guidelines 1 Addiction/Abuser Drug - Past or Present Presently Recovered - AA for last 2 years 2 Aids 3 Alcoholic Presently Recovered - AA for last 2 years 4
ODJFS Care Management File and Submission Specifications
ODJFS Care Management File and Submission Specifications Ohio Department of Job & Family Services Office of Ohio Health Plans Bureau of Health Services Research Version 3.7 Contact: Kendy Markman or James
EXCESS LOSS INSURANCE POLICY Non-Participating
2000 North Classen Boulevard, Oklahoma City, Oklahoma 73106 EXCESS LOSS INSURANCE POLICY Non-Participating PLEASE READ CAREFULLY Policyholder Name: Principal Address: Policy Number: Effective Date: Expiration
ICD 10 ICD 9. 14, 000 codes No laterality Limited severity parameters No placeholders 3-5 digits
ICD 10 Conversion 1 Why Change? ICD 9 14, 000 codes No laterality Limited severity parameters No placeholders 3-5 digits 1 2 3 4 5 ICD 10 69,000+ codes Indicates Rt or Lt Extensive severity parameters
HCIM ICD-10 Training Online Course Catalog August 2015
HCIM ICD-10 Training Online Course Catalog August 2015 Course/Content Duration Quiz Duration CME Credits Assessments: Assessment: Provider - Baseline - E/M Emergency Department 45 5/1/2015 Assessment:
CHAPTER 2. Neoplasms (C00-D49) March 2014. 2014 MVP Health Care, Inc.
Neoplasms (C00-D49) March 2014 2014 MVP Health Care, Inc. CHAPTER SPECIFIC CATEGORY CODE BLOCKS C00-C14 Malignant neoplasms of lip, oral cavity and pharynx C15-C26 Malignant neoplasms of digestive organs
ICD-10 in the Provider Newsletter
ICD-10 in the Provider Newsletter ICD-10 CM Code Structure, July 2013 ICD-10 Implementation, April 2013 ICD-10 Manual, January 2013 ICD-10 Back on Track, October 2012 ICD-10 Training, July 2012 ICD-10
ICD-9-CM/ICD-10-CM Codes for MNT
/ Codes for MNT ICD (International Classification of Diseases) codes are used by physicians and medical coders to assign medical diagnoses to individual patients. It is not within the scope of practice
The effect of the introduction of ICD-10 on cancer mortality trends in England and Wales
The effect of the introduction of ICD-10 on cancer mortality trends in Anita Brock, Clare Griffiths and Cleo Rooney, Offi ce for INTRODUCTION From January 2001 deaths in have been coded to the Tenth Revision
Critical Illness with Term Assurance
AIG Life Critical Illness with Term Assurance Our comprehensive Critical Illness with Term Assurance delivers more value and quality to the customer and their family than ever before. It is designed to
NCD for Lipids Testing
Applicable CPT Code(s): NCD for Lipids Testing 80061 Lipid panel 82465 Cholesterol, serum or whole blood, total 83700 Lipoprotein, blood; electrophoretic separation and quantitation 83701 Lipoprotein blood;
Systemic Health: Pathology
Page 1 Systemic Health: Pathology A. General Health 2. Detailed history with regards to differential diagnosis of fatigue, weight loss, fever, headache, dizziness, and malaise 3. Presentations involving
Breaking the Code: ICD-9-CM Coding in Details
Breaking the Code: ICD-9-CM Coding in Details ICD-9-CM diagnosis codes are 3- to 5-digit codes used to describe the clinical reason for a patient s treatment. They do not describe the service performed,
Medical Specialties Guide
Medical Specialties Guide Allergy And Immunology Specialists in this field treat disorders related to how the body reacts to foreign substances. They treat such things as seasonal allergies, eczema, asthma,
Statistical Report on Health
Statistical Report on Health Part II Mortality Status (1996~24) Table of Contents Table of Contents...2 List of Tables...4 List of Figures...5 List of Abbreviations...6 List of Abbreviations...6 Introduction...7
ICD-10 Provider Preparation
ICD-10 Provider Preparation After browsing this slide deck, the viewer will become more familiar with the following information: What are the origins of ICD-10? Why transition to ICD-10? Why ICD-10 matters.
2012 LONG TERM DISABILITY CLAIMS REVIEW
2012 LONG TERM DISABILITY CLAIMS REVIEW The 2012 Council for Disability Awareness Long Term Disability Claims Review Since 2005, the Council for Disability Awareness (CDA) has conducted a proprietary annual
2FORMATS AND CONVENTIONS
2FORMATS AND CONVENTIONS OF DIAGNOSIS CODING SYSTEMS Learning Outcomes After completing this chapter, students should be able to 2.1 Explain the layout of the ICD-9-CM and ICD-10-CM manuals. 2.2 Differentiate
Utilization and Costs Data Points #5
Prevalence and Medicare reimbursement by recurrent International Classification of Diseases categories, 26- Utilization and Costs Data Points #5 The United States spends more on health care per capita
Closed Sub-TOI: L08.000 Life - Other Co Tr Num: BANRD-01 State Status: Approved-Closed
Project Name/Number: / 01 Filing at a Glance Company: Banner Life Insurance Company SERFF Tr Num: FNBL-126416557 State: Arkansas TOI: L08 Life - Other SERFF Status: Closed-Approved- State Tr Num: 44441
Medical Surgical Nursing (Elsevier)
1 of 6 I. The Musculoskeletal System Medical Surgical Nursing (Elsevier) 1. Med/Surg: Musculoskeletal System: The Comprehensive Health History 2. Med/Surg: Musculoskeletal System: A Nursing Approach to
Diagnosis Codes for Pregnancy and Complications of Pregnancy
This list is for informational purposes only and is not a binding or definitive list of covered conditions. It is not a guarantee of coverage; coverage depends on the available benefits and eligibility
5 Burden of disease and injury
5 Burden of disease and injury 5.1 Overview In this chapter, we present the results of the Australian Burden of Disease and Injury Study for the total disease burden measured in by age, sex and cause for
Application for a Medical Impairment Rating (MIR)
STATE OF TENNESSEE DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT Workers Compensation Division Medical Impairment Rating Program 220 French Landing Drive Nashville, TN 37243-1002 Phone (615) 253-1613 Fax
Data M. Möhner et al. Fb 937 BfAA 2001. Compiled by Sebastian Pflugbeil 09 / 2013. Gesellschaft für Strahlenschutz e.v. Dr. Sebastian Pflugbeil
Health insurance certificate in the WISMUT mine 1985 1989 and comparison with German Democratic Republic (GDR, East Germany) reference data 1989 for s and for selected diagnoses (ICD-9 numbers) 100%: WISMUT
ICD-10-CM KEVIN SOLINSKY, CPC, CPC-I, CEDC, CEMC PRESIDENT HEALTHCARE CODING CONSULTANTS, LLC 480-200-4590
ICD-10-CM KEVIN SOLINSKY, CPC, CPC-I, CEDC, CEMC PRESIDENT HEALTHCARE CODING CONSULTANTS, LLC 480-200-4590 ICD-10 FINAL RULE Implementation date October 1, 2014. ICD-9-CM codes will not be accepted by
Pathology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Pathology and Top 25 codes
Pathology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Pathology and Top 25 codes Chapter 2 Neoplasms (C00-D49) Classification improvements Code expansions Significant expansions or revisions
GUIDE. Prepare for Your Phone Interview and Medical Exam.
GUIDE Prepare for Your Phone Interview and Medical Exam. WHAT YOU NEED TO HAVE, KNOW, AND DO. All information gathered during the interview and exam will be shared only with those who need it in order
ICD-9-CM coding for patients with Spinal Cord Injury*
ICD-9-CM coding for patients with Spinal Cord Injury* indicates intervening codes have been left out of this list. OTHER DISORDERS OF THE CENTRAL NERVOUS SYSTEM (340-349) 344 Other paralytic syndromes
NATIONAL CENTER FOR HEALTH STATISTICS ICD-9* RECODES. Of Selected Causes of Death For Deaths Occurring From 1979-1998
NATIONAL CENTER FOR HEALTH STATISTICS ICD-9* RECODES Of Selected Causes of Death For Deaths Occurring From 1979-1998 For purposes of publishing data on causes of death over the period 1979-1998, NCHS groups
C CS. California Children Services Alameda County
C CS California Children Services Alameda County The California Children Services (CCS) Program strives to assure access to medical services essential to the health and well-being of children with catastrophic
LIFE SETTLEMENT QUALIFIER
LIFE SETTLEMENT QUALIFIER D I R E C T SECTION 1 PRIMARY CONTACT Name _ Primary phone number ( ) Email Best time to call morning afternoon evening SECTION 2 POLICY DETAILS Life Insurance Policy Information
Measure Name: Low Back Pain Imaging Studies Measure Code: LBP Lab Data: N
Measure Name: Low Back Pain Imaging Studies Owner: NCQA (LBP) Measure Code: LBP Lab Data: N Rule Description: General Criteria Summary The percentage of patients 18-50 years of age who had a principal
SECTION 4 COSTS FOR INPATIENT HOSPITAL STAYS HIGHLIGHTS
SECTION 4 COSTS FOR INPATIENT HOSPITAL STAYS EXHIBIT 4.1 Cost by Principal Diagnosis... 44 EXHIBIT 4.2 Cost Factors Accounting for Growth by Principal Diagnosis... 47 EXHIBIT 4.3 Cost by Age... 49 EXHIBIT
Number. Source: Vital Records, M CDPH
Epidemiology of Cancer in Department of Public Health Revised April 212 Introduction The general public is very concerned about cancer in the community. Many residents believe that cancer rates are high
Coding Transition Tip Sheet ICD-9 to ICD-10
Coding Transition Tip Sheet ICD-9 to ICD-9 Consists of three to five digits Consists of three to seven digits First digit numeric or alpha (E or V codes) First character always alpha (all letters used
Certified Registered Nurse Anesthetist ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for CRNA s and Top 25 Codes
Certified Registered Nurse Anesthetist ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for CRNA s and Top 25 Codes Chapter 2 Neoplasms (C00-D49) Classification improvements Code expansions Significant
The insurance company checked above (Company) is responsible for the obligation and payment of benefits under any policy that it may issue.
American International Life Assurance Company of New York* Home Office: 80 Pine Street, New York, NY 10005 The United States Life Insurance Company in the City of New York* Home Office: 830 Third Avenue,
CMS CLINICAL ELIGIBILITY ATTESTATION
CMS CLINICAL ELIGIBILITY ATTESTATION Patient Name: DOB: Medicaid and/or KidCare ID: Parent/Legal Guardian Name: Phone number: Initial all that Apply: Initials ICD 10 Descriptor Certain infectious and parasitic
Medicaid Disability Manual
Part B The following sections apply to individuals under age 18. If the criteria in Part B do not apply, Part A criteria may be used when those criteria give appropriate consideration to the effects of
How To Read The Long Term Disability Claims Review
2013 LONG TERM DISABILITY CLAIMS REVIEW The 2013 Council for Disability Awareness Long Term Disability Claims Review Since 2005, the Council for Disability Awareness (CDA) has conducted a proprietary annual
SUPER CARE CRITICAL ILLNESS PROTECTOR
SUPER CARE CRITICAL ILLNESS PROTECTOR At ACE Life, we are committed to helping our valued customers achieve financial security and have a peace of mind through our comprehensive range of life insurance
Application Form. New application Change my current plan/deductible. Add spouse/partner/dependents Reinstatement
Application Form Important: Please make sure all the information required on this health insurance application has been provided. Best Doctors Insurance Limited reserves the right to contact the if a question
Mortality statistics and road traffic accidents in the UK
Mortality statistics and road traffic accidents in the UK An RAC Foundation Briefing Note for the UN Decade of Action for Road Safety In 2009 2,605 people died in road traffic accidents in the UK. While
Home Health Care ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Home Health Care and Top 20 codes
Home Health Care ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Home Health Care and Top 20 codes Chapter 4: Endocrine, Nutritional and Metabolic Diseases (E00-E99) ICD-10-CM diabetes mellitus
Substandard Underwriting Structured Settlements
Substandard Underwriting Structured Settlements Structures 101-Back to Basics February 20-22, 2013 Las Vegas, Nevada Rosemary Brindamour BSN CSSC Chief Medical Underwriter Structured Settlement Underwriting
ICD-9-CM Official Guidelines For Coding and Reporting Effective October 1, 2002 Narrative changes appear in bold text
ICD-9-CM Official Guidelines For Coding and Reporting Effective October 1, 2002 Narrative changes appear in bold text The Centers for Medicare and Medicaid Services (CMS) formerly the Health Care Financing
Underwriting and Rate Information
Underwriting and Rate Information 2013 New Sales in The following section applies to. Rates and Underwriting vary by state. Please refer to the appropriate statespecific handbook for information specific
Application for Individual Health Insurance
1 of 6 New policy: Policy reinstatement: Dependent addition: Change of plan/option: I. Applicant information 1. Last Name(s): 2. First Name: 3. Middle Initial: 4. Address: 5. City: 6. State: 9. Phone Number
CHARGES FOR DRUG-RELATED INPATIENT HOSPITALIZATIONS AND EMERGENCY DEPARTMENT VISITS IN KENTUCKY, 2009-2013
CHARGES FOR DRUG-RELATED INPATIENT HOSPITALIZATIONS AND EMERGENCY DEPARTMENT VISITS IN KENTUCKY, 2009-2013 Prepared for the Kentucky Injury Prevention & Research Center by: Huong Luu, MD, MPH W. Jay Christian,
Crisis Defender & Early Crisis Protector
Crisis Defender & Early Crisis Protector MEDICAL Shield yourself with Prudential's comprehensive critical illnesses coverage! It s now a comprehensive crisis coverage with Crisis Defender & Early Crisis
Work-Related Injuries and Illnesses of Public Workers: A Review of Employees Compensation Claims from GSIS, 2010-2012
Work-Related Injuries and Illnesses of Public Workers: A Review of Employees Compensation Claims from GSIS, 2010-2012 Marissa Lomuntad-San Jose, MD, MOH Supervising Occupational Health Officer Occupational
Cardiology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Cardiology
Cardiology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Cardiology Chapter 4: Endocrine, Nutritional, and Metabolic Diseases (E00-E89) The diabetes mellitus codes are combination codes
A review of the Condition Present on Admission (CPoA) variable
A review of the Condition Present on Admission (C) variable Miles Utz, Rachael Wills, Stephanie Callaghan, Taku Endo, Lachlan Mortimer, Sandra Martyn, Trisha Johnston, Corrie Martin Health Statistics Centre,
2014 long term Disability Claims Review
2014 long term Disability Claims Review The 2014 Council for Disability Awareness Long Term Disability Claims Review Since 2005, the Council for Disability Awareness (CDA) has conducted an exclusive annual
Guidelines Most Significantly Affected Under ICD-10-CM. May 29, 2013
Guidelines Most Significantly Affected Under ICD-10-CM May 29, 2013 Guidelines Most Significantly Affected Under ICD-10-CM A look at the new system and how it compares to ICD-9-CM Presented by Therese
Present on Admission Reporting Guidelines
Introduction Present on Admission Reporting Guidelines These guidelines are to be used as a supplement to the ICD-9-CM Official Guidelines for Coding and Reporting to facilitate the assignment of the Present
Highlights of the Revised Official ICD-9-CM Guidelines for Coding and Reporting Effective October 1, 2008
Highlights of the Revised Official ICD-9-CM Guidelines for Coding and Reporting Effective October 1, 2008 Please refer to the complete ICD-9-CM Official Guidelines for Coding and Reporting posted on this
Agent Reference Guide
Agent Reference Guide For Guaranteed Cost or Price Estimate Only Funeral Planning SM Forethought Encore Advance Whole life insurance issued by Forethought Life Insurance Company FOR AGENT USE ONLY NOT
Phoenix Remembrance Life
Phoenix Remembrance Life W e You Asked New Printer- Friendly Design! D e l i v e r e d Field Underwriting Guide For agent use only. Not for distribution to the public as sales literature. Phoenix Remembrance
ICD-10: Navigating the Change. Presented by: Shelley Garrett, CPC, CMC, CMOM, CMIS
ICD-10: Navigating the Change Presented by: Shelley Garrett, CPC, CMC, CMOM, CMIS A journey of a thousand miles begins with a single step -Confucius 5010 Conversion January 1, 2012 5010 Conversion Version
Application for Critical Care Insurance to: Guarantee Trust Life Insurance Company 1275 Milwaukee Avenue, Glenview, IL 60025 (800) 338-7452
Application for Critical Care Insurance to: Guarantee Trust Life Insurance Company 1275 Milwaukee Avenue, Glenview, IL 60025 (800) 338-7452 AGENT NOTE: Please pre-qualify the Applicant (s) with Section
ICD-10 DELAY: Relief or Grief?
ICD-10 DELAY: Relief or Grief? PETER EDU MD, CPC, CPC-I, CCS Healthcare Sr. Training Manager TeleDevelopment Services, Inc. OUTLINE 1. Background 2. What s new with ICD-10? 3. Impact of ICD-10-CM implementation
For customers Friends Life Individual Protection. Childcover benefit
For customers Friends Life Individual Protection Childcover benefit Helping to protect the whole family Most parents don t want to think about what would happen if their child became critically ill. However,
Critical illness is best dealt with early
PRIME CARE PRO PROTECTION Critical illness is best dealt with early 93 Critical Illnesses and specified illnesses protection Life Insurance Savings Comprehensive and unique protection for Early Stage Critical
Aetna Individual Medicare Supplement Plan Application Aetna Life Insurance Company PO Box 13547, Pensacola, FL 32591-3547
Aetna Individual Medicare Supplement Plan Application Aetna Life Insurance Company PO Box 13547, Pensacola, FL 32591-3547 INSTRUCTIONS: To be considered complete, all sections on this form must be filled
Individual Health Insurance Application
Individual Health Insurance Application The Insurer retains the right to contact the applicant if any question is not explained in detail or if additional information is required. New policy Additional
ICD-9-CM Official Guidelines for Coding and Reporting
Narrative changes appear in bold text Items underlined have been moved within the guidelines since April 2005 The guidelines include the updated V Code Table The Centers for Medicare and Medicaid Services
CSA FRATERNAL LIFE A Fraternal Benefit Society P.O. Box 249, Lombard, Illinois 60148. Application for Life Insurance
FOUNDED MARCH 4, 1854 Personal Information 1. Full name of Proposed Insured: Lodge Name: CSA FRATERNAL LIFE A Fraternal Benefit Society P.O. Box 249, Lombard, Illinois 60148 Application for Life Insurance
BIO 137: CHAPTER 1 OBJECTIVES
BIO 137: CHAPTER 1 OBJECTIVES 1. Define the terms anatomy and physiology, and explain their relationship using an example of a human structure with its corresponding function. A. ANATOMY = the study of
CHAPTER 9 DISEASES OF THE CIRCULATORY SYSTEM (I00-I99)
CHAPTER 9 DISEASES OF THE CIRCULATORY SYSTEM (I00-I99) March 2014 2014 MVP Health Care, Inc. CHAPTER 9 CHAPTER SPECIFIC CATEGORY CODE BLOCKS I00-I02 Acute rheumatic fever I05-I09 Chronic rheumatic heart
C a nc e r C e nter. Annual Registry Report
C a nc e r C e nter Annual Registry Report 214 214 Cancer Registry Report Larraine A. Tooker, CTR Please note that the 214 Cancer Registry Annual Report is created in 214, but it reflects data on cases
Term Critical Illness Insurance
Term Critical Illness Insurance PRODUCT GUIDE 5368-01A-JUL14 ASSUMPTION LIFE This document is a summary of the various features of Assumption Life's products. It is neither a contract nor an insurance
Home Address (Street/PO Box) F M Date of Birth (mm/dd/yyyy) State Zip Code Home Phone # Scheduled Number of Work Hours per Week Work Phone #
Unum Life Insurance Company of America 2211 Congress Street Portland, Maine 04122 APPLICATION FOR GROUP CRITICAL ILLNESS INSURANCE Evidence of Insurability Application Type: New Enrollee Change to Existing
Life Insurance Application Form
Life Insurance Application Form INSTRUCTION To be completed by all applicants PERSONAL DETAILS Surname First name Middle name Sex Female Male Marital status (please tick) Single Married Other Current residential
CCS - Does CCS provide Counseling or Support Services? CCS - Are there any costs to me? CCS - What papers should I bring?
CCS - Does CCS provide Counseling or Support Services? CCS - Are there any costs to me? CCS - What papers should I bring? CCS - What are the steps to CCS services? CCS - How is my privacy protected? CCS
Day Rehab ICD-10 documentation
Day Rehab documentation Seven key impacts to documentation 1. Disease or disorder site 2. Acuity and/or encounter status of treatment 3. Etiology, causative agent, or disease type and injury/ poisoning
Enjoy a position of vantage, come what may.
Enjoy a position of vantage, come what may. prucrisis covervantage While you have achieved much in life and you and your family enjoy the benefits of success, there may be times when the unexpected happens.
RESEARCH UPDATE. California Workers Compensation Reform Monitoring. Part 3: Temporary Disability Outcomes Accident Years 2002 2007 Claims Experience
January 2009 RESEARCH UPDATE California Workers Compensation Reform Monitoring Part 3: Temporary Disability Outcomes Accident Years 2002 2007 Claims Experience by Alex Swedlow, MHSA and John Ireland, MHSA
THE HUMAN BODY SYSTEMS
Name Period Date THE HUMAN BODY SYSTEMS System Function Diagram Major Organs Digestive 1. take in food (ingestion) 2. digest food into smaller molecules and absorb nutrients 3. remove undigestable food
ICD 10 CM IMPLEMENTATION DATE OCT 1, 2015
Presented by: Teri Romano, RN, MBA, CPC, CMDP ICD 10 CM IMPLEMENTATION DATE OCT 1, 2015 Source: http://journal.ahima.org/2015/02/04/us house committee to hold hearing on icd 10 implementation/ 2 2015 Web_Non
LIPID PANEL CHOLESTEROL LIPOPROTEIN, ELECTROPHORETIC SEPARATION LIPOPROTEIN, DIRECT MEASUREMENT (HDL) LDL DIRECT TRIGLYCERIDES
Test Code Test Name CPT CHOL Cholesterol, Serum 82465 HDL HDL, (High Density Lipoprotein) 83718 TRIG Triglycerides, Serum 84478 FTRIG Triglycerides (Fluid) 84478 LIPID Lipid Panel 80061 LDL LDL (Low Density
SUPPLEMENTARY NOTES. Personal General Insurance (4 th Edition) Date Of Issue: 1 October 2014
SUPPLEMENTARY NOTES Personal General Insurance (4 th Edition) Date Of Issue: 1 October 2014 The following amendments have NOT been incorporated in the Study Guide. They should be marked up in the Study
190.25 - Alpha-fetoprotein
Other Names/Abbreviations AFP 190.25 - Alpha-fetoprotein Alpha-fetoprotein (AFP) is a polysaccharide found in some carcinomas. It is effective as a biochemical marker for monitoring the response of certain
Employee Critical Illness Option
ECIO Employee Critical Illness Option Financial Protection for the Unexpected Includes Cancer Benefit First Occurrence Additional Occurrence Reoccurrence Spouse Coverage Available Child Coverage at No
NOT FOR USE WITH THE PUBLIC. FOR PRODUCER USE ONLY.
ForeCareTM Fixed Annuity Facts and Factors NOT FOR USE WITH THE PUBLIC. FOR PRODUCER USE ONLY. Long-Term Care The Big Picture When you think about long-term care, what picture comes to mind? Do you think