№ files_lp_4_process_2_57513
File format: docx
Character count: 59222
File size: 87 KB
This document outlines procedures for handling specific healthcare claims denials and appeals related to procedure codes, modifiers, and other billing discrepancies.
Year:
2017
Region / City:
Not specified
Subject:
Healthcare claims processing
Document Type:
Policy update
Organization:
Healthcare payer systems
Author:
Not specified
Target Audience:
Healthcare providers, billing professionals
Period of Validity:
September 1, 2017 onward
Date of Approval:
September 1, 2017
Date of Changes:
September 1, 2017
Note:
Contextual description
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Note:
Year
Theme:
Blood Transfusion, ABO Grouping
Document Type:
Procedure
Target Audience:
Medical Laboratory Staff
Year:
2023
Note:
Region / City
Subject:
Billing Requirements for Drugs and Biologicals with Discarded Amounts
Document Type:
Policy
Organization / Institution:
SummaCare, Apex Summa Health Management Company, Summa Insurance Company
Target Audience:
Providers, Healthcare Administrators, Claims Department
Effective Period:
From 01/01/2017
Approval Date:
08/15/2023
Review Date:
Every 2 years or as necessary
Compliance Statement:
All members of the workforce are responsible for compliance with this policy.
Monitoring and Auditing:
Claims Department
Documentation Retention:
Minimum of 10 years
Purpose:
To outline the billing requirements for drugs and biologicals with unused and discarded amounts from single-dose containers or single-use packages.
Description:
Guidelines on proper billing procedures for drugs and biologicals, including the use of JW and JZ modifiers for discarded drug amounts or no wastage in single-dose vials, applicable to providers and insurers.
Note:
Year
Note:
Year
Context:
This is a technical document detailing the specifications and compliance checks for prime movers, including information about engine and vehicle components, modifications, and their compliance with safety and regulatory standards.
Year:
2026
Region / City:
United States, California
Topic:
Healthcare Billing Procedures
Document Type:
Instructional Guide
Organization / Agency:
California Department of Alcohol and Drug Programs
Author:
Internal Documentation Team
Target Audience:
Healthcare billing staff and administrators
Applicable Period:
2026
Date of Approval:
2026-02-01
Procedure Type:
Contingency Management Service Billing
Platform:
Medi-Cal, Commercial Insurance, Medicare
Note:
Year
Year:
Not specified
Region / City:
Not specified
Document type:
Technical and compliance report
Vehicle make:
Not specified
Vehicle model:
Not specified
Month and year of manufacture:
Not specified
VIN:
Not specified
Vehicle chassis number:
Not specified
Vehicle modifier:
Not specified
Examiner / certifying authority:
AVE
S12 design certificate number:
Not specified
Axle configuration:
Front and rear axle groups
Brake system details:
Included, with calculated braking performance and ERC deceleration
Tow couplings:
Front and rear specified with D-rating
Tyre size and suspension:
Detailed per component
Compliance with standards:
ADR 38/.., ADR 62/..
Modification assessment:
Yes/No/N/A checklist for ATM, GTM, chassis construction, braking, and certification
Authorisation:
Certificate signed by certifying authority with modification certificate number
Year:
2026
Region / City:
Gothenburg, Sweden
Topic:
Vehicle accessibility and adaptation
Document type:
Press release
Organization:
BraunAbility Europe
Parent company:
Investor’s Patricia Industries
Vehicles covered:
Ford Transit V363, Ford Custom V362
Certification:
Ford Qualified Vehicle Modifier (QVM)
Global presence:
USA, Sweden, Denmark, UK, over 60 countries
Employees:
over 1,400
Key personnel:
Stefan Larsson, Tobias Hägg
Industry recognition:
accredited testing centre, pioneer in safety and quality
Year:
2025
Jurisdiction:
Wisconsin
Country:
United States
Document type:
Audit reporting requirements and reporting form
Program:
Managed Long-Term Care
Administering authority:
Department of Health Services, Division of Medicaid Services
Form number:
F-02022
Date of issue:
11/2025
Applicable entities:
Managed Care Organizations (MCOs)
Audit performer:
Independent certified public accountant (CPA) firm
Audit scope:
Claims processing for long-term care, acute, and primary services
Minimum sample size:
70 LTC claims; 85 total claims for FCP and PACE programs
Effective policy reference:
Residential services encounter reporting effective 02/01/2021
Coverage systems referenced:
ForwardHealth, DHS data warehouse
Year:
2025
Region / City:
Massachusetts
Subject:
Health Insurance, Medicaid, and CHIP
Document Type:
Implementation Guide
Organization / Institution:
MassHealth
Author:
MassHealth
Target Audience:
Healthcare providers, trading partners, and Managed Care Entities
Effective Period:
From January 1, 2012
Approval Date:
August 2025
Date of Changes:
Future updates will be included in subsequent versions
Context:
Implementation guide for electronic healthcare transactions, specifically for Medicaid and CHIP encounter data reporting under the HIPAA standards for MassHealth Managed Care Entities.
Year:
2025
Region / City:
Massachusetts
Subject:
Healthcare, Medicaid, Claims Reporting
Document Type:
Companion Guide
Organization:
MassHealth
Author:
MassHealth
Target Audience:
Healthcare providers, Trading Partners, Managed Care Entities (MCEs)
Effective Period:
From August 2025
Approval Date:
August 2025
Revision Date:
Not specified
This document is a companion guide for the ASC X12N 005010X299A1 Post-Adjudicated Claims Data Reporting:
Institutional standard, aimed at assisting MassHealth Managed Care Entities in reporting claims electronically in compliance with HIPAA.
Year:
2004
Region:
Wales
Document type:
Protocol
Organization:
NHS Wales Shared Services Partnership – Primary Care Services (NWSSP–PCS)
Target audience:
Health Boards, General Medical Practices
Subject:
Post Payment Verification, Enhanced Service Claims
Date approved:
April 2004
Relevant legislation:
Statement of Financial Entitlement (SFE), GDPR, Department of Health guidelines on patient information (DGM (96) 43)
Note:
Year
Subject:
Eviction, Small Claims
Document Type:
Legal Agreement
Target Audience:
Legal professionals, plaintiffs, defendants
State:
Wisconsin
Court:
Circuit Court
County:
Unspecified
Case type:
Small claims
Document type:
Court stipulation
Subject matter:
Dismissal of non-eviction case
Parties:
Plaintiff(s) and Defendant(s)
Agreement types:
Payment agreement; Other agreement
Related forms:
SC5420VA/VB; SC-5410VA/VB
Signature requirement:
Plaintiff(s) and Defendant(s)
Notarization requirement:
Not required
Year:
2026
Region / City:
Wisconsin
Subject:
Eviction procedure, noncompliance with stipulation
Document type:
Legal declaration
Authority / Organization:
Wisconsin Circuit Court
Author:
Plaintiff
Target audience:
Legal professionals, courts
Effective period:
Not specified
Approval date:
Not specified
Amendment date:
Not specified
Year:
2023
Region / city:
Wisconsin
Subject:
Small Claims Court Procedures
Document type:
Guide
Issuing body:
Wisconsin Court System
Author:
Wisconsin Court System
Target audience:
General public, individuals involved in small claims
Effective period:
N/A
Approval date:
N/A
Modification date:
N/A
Year:
2025
Region / city:
Victoria, Australia
Document Type:
FAQ
Organization / Institution:
Australian Education Union (AEU)
Author:
AEU
Target audience:
AEU members, Teachers, Educational Workers
Effective Period:
2025
Approval Date:
2025
Modification Date:
2025
Year:
2024
Region / City:
Gauteng / Pretoria / Johannesburg
Subject:
Legal Procedure
Document Type:
Trial Practice Note Template
Organization / Institution:
High Court of South Africa
Author:
Not specified
Target Audience:
Legal professionals, Plaintiffs, Defendants
Period of validity:
N/A
Approval Date:
N/A
Date of amendments:
N/A
Year:
2024
Region / City:
New Zealand, Australia
Theme:
Labelling regulations for alcoholic beverages
Document Type:
Regulatory Guidelines
Target Audience:
Brewers, Food and Beverage Industry
Period of Validity:
Ongoing (subject to updates)
Approval Date:
February 2024
Date of Changes:
N/A
Year:
2023
Document type:
Regulatory addendum
Issuing body:
Department of Health
Version:
V2012
Subject:
Telemedicine services reimbursement and tariff pricing
Rule effective date:
31 July 2023
Replaces:
Addendum 3
Scope:
All healthcare facilities
Applicable specialties:
All specialties excluding Psychiatry/Psychology; Psychiatry/Psychology
Payment model:
Telemedicine services
Tariff system:
Mandatory Tariff Pricelist Application Rules
Coding system:
CPT
CPT codes covered:
99441, 99442, 99443, 99091, 99446, 99447, 99448, 98966, 98967, 98968, 90791, 90792, 90833
Pricing currency:
Not specified
Compliance requirement:
Minimum telemedicine technology requirements as prerequisite for payment eligibility