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Help & FAQ


Frequently Asked Questions

In this section, we provide detailed answers to common questions about our medical billing services, helping you understand how our solutions can improve revenue cycle management and streamline billing processes for your practice.

A recipient may be billed for services that have been determined as non-covered or exceeding the services limit for recipients over the age of 21. Recipients are also responsible for all services rendered after his/her eligibility has ended. Providers may not bill recipients in instances where provider billing errors have caused a denied claim.

In order to bill a recipient for a non-covered service, the recipient must be informed both verbally and in writing that he/she will be responsible for payment of the services.

Source: Louisiana Medicaid Message Board

Review the insurance companies’ medical policy on the denied service located on insurances website. You can appeal the denial if you have documentation supporting you met the requirements found in the policy.

  1. The initial consultation or evaluation of the problem by the surgeon to determine the need for surgery. Append modifier 57 if decision was made the day before your surgery.
  2. Visits unrelated to the diagnosis for which the surgical procedure is performed, unless the visits occur due to complications of the surgery. Append modifier 24 to your visit.
  3. Treatment for the underlying condition or an added course of treatment which is not part of normal recovery from surgery. Append modifier 24 to your visit.