Claims Corner

Claims Corner is an online resource for updated information on claims policy, best practices for claims coding, regulatory-driven payment methodology and other useful claims-related tips. Visit us often to view important claims topics and updates that may have an impact on your practice's management system. Select any topic of interest to read the expanded discussion.

How to Submit Medicare PPO Claims
We encourage you to review instructions on the proper way to submit Medicare PPO claims to ensure appropriate and efficient reimbursement.

FAIR Health Replaces HIAA/Ingenix in 2011
In 2011, FAIR Health will replace HIAA/Ingenix or similar language, in our Prevailing Provider Fee Schedules, where documented in our provider agreements.

EDI Transactions: What to Know to Make Them Work for You
Electronic data interchange transactions help thousands of practitioners manage their practices more effectively. EmblemHealth supports HIPAA-compliant electronic data interchange (EDI) transactions.

Changes to the In-Office Testing List for CompreHealth, HIP and Vytra Plans
The In-Office Testing List, as published in the EmblemHealth Provider Manual, has been updated to allow certain in-office tests to be performed by additional types of specialists.