Learning Resources
Frequently Asked Questions
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Can you use the Web Tool for adjustments, if you filed through a clearinghouse?Yes, you may submit an adjustment through the Web Tool, even if the original claim was filed using a clearinghouse – as long as it is within 15-18 months. However, UB-04 (Institutional) billers must file adjustments in the same medium as the original claim. | |
Do you have to put in diagnosis codes?If the service you are providing requires the use of a diagnosis code, then you must enter the diagnosis code with your claim information. | |
Do you have to put the last 4 digits of the zip code for Claims Entry?Yes; you can find zip codes on the US Postal Services website: www.usps.com. Click on Look Up a Zip Code™ | |
Do you have to submit claims through Web Tool?No, you may use other options like hard copy or vendor/clearing house. | |
How do I know the charge?You can find the charge for the service in your provider manual. | |
How far back can you bill?Within 12 months | |
How far back can you file a void?15 - 18 months | |
How long will a Web Tool claim stay out as a draft?Three months. | |
If you are missing information, will the Web Tool process the claim anyway?Yes and no; there are basic required fields that are denoted by asterisks, however if you forget modifiers, the Web Tool won’t recognize that. | |