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Industry News: Highmark Medicare Services

Friday, November 18, 2011

To facilitate prompt and accurate credit of unsolicited monies or voluntary refunds to Medicare, a Return of Monies form has been developed. Please use the Return of Monies form (8322) for Part B if you receive a Medicare payment in error.

Wednesday, September 01, 2010

To assist electronic billing customers with error messages received on the electronic reports, an interactive 1450 (UB-04) form has been developed as a crosswalk. This crosswalk is an interactive feature that displays the appropriate loops, segments, and qualifier detail when clicking on each block of the 1450 (UB-04) sample claim form. A crosswalk chart is also available to provide a complete list of the crosswalk information.

Friday, August 13, 2010

During the first quarter of 2010, 158 CERT errors were assessed for all Part B contracts within Highmark Medicare Services (HMS). Of those 158 errors, 77 errors were due to insufficient documentation (error code 21), 40 were due to incorrect coding (error code 31), 38 were due to medical necessity (error code 25), and 3 was due to improper documentation submitted to the CERT contractor (error code 16).

 The Part B CERT errors that were received for Highmark Medicare Services during this quarter remain relatively unchanged from the last quarter.