Medicare claim submission errors for February per Novitas

Written by Reed Tinsley | March 13, 2018

 

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Explanation of Medicare Benefits Message

Description

Resolution

1

96

Non-covered charge.

Prior to performing or billing a service, ensure that the service is covered under Medicare. Please refer to the Centers for Medicare & Medicaid Services Internet Only Manual, 100-02, Chapter 16.

2

109

Claim not covered by this payer/contractor.

This denial indicates that the service is one that is processed or paid by another contractor.

Examples of these types of service are:

Durable Medical Equipment
Hospice related services
Medicare Advantage

You must send the claim to the correct payer/contractor.

3

18

Duplicate claim/service.

Please check claim status through the IVR to see if another claim was paid or is currently being processed. To prevent duplicate denials, allow us sufficient time to process a claim before submitting a second.

4

50

These are non-covered services because this is not deemed a 'medical necessity' by the payer.

Please ensure to follow Medicare guidelines, national and local coverage determinations for the service billed.

References:

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.

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