Question
Are the subscriber and the patient the same person? What is the code for the patients relationship to the insured? What is the claim filing
- Are the subscriber and the patient the same person?
- What is the code for the patients relationship to the insured?
- What is the claim filing indicator code?
- Claim control numbers are created by adding the eight-digit date to the patient account number, as in PORCEJE0-01012016.
- A copayment of $15 is collected from each Oxford PPO patient at the time of the visit. A copayment of $10 is collected for Oxford HMO.
- The practice uses NDC as its clearinghouse to transmit claims.
- The necessary data for the payer and the clearinghouse are stored in the programs databases.
Provider Information | |
Billing Provider | Valley Associates, PC NPI 1476543215 |
Address | 1400 West Center Street Toledo, OH 43601-0213 |
Telephone | 555-967-0303 |
Employer ID Number | 16-1234567 |
Rendering Provider | Christopher M. Connolly, MD |
NPI | 8877365552 |
Oxford PPO Provider Number | 1011 |
Oxford HMO Provider Number | 2567 |
Assignment | Accepts |
Case: From the Patient Information Form:
Name | Kalpesh Shah |
Sex | M |
Birth Date | 01/21/2005 |
Assignment of Benefits | Y |
Signature on File | Y |
Primary Insurance | |
Insured | Raj Shah |
Patient Relationship to Insured | Son |
Insureds Birth Date | 02/16/1976 |
Insureds Sex | M |
Insureds Address | 1433 Third Avenue, Cleveland, OH 44101-1234 |
Insureds Employer | Cleveland Savings Bank |
Insurance Policy Group Number | G0904 |
Insurance Plan/ Program Name | Oxford Freedom PPO |
Member ID | 3302112090X |
Encounter Form | See below. |
Step by Step Solution
There are 3 Steps involved in it
Step: 1
Get Instant Access to Expert-Tailored Solutions
See step-by-step solutions with expert insights and AI powered tools for academic success
Step: 2
Step: 3
Ace Your Homework with AI
Get the answers you need in no time with our AI-driven, step-by-step assistance
Get Started