Insurance
Eligibility and Benefits (E&B) Verification
Overview The Eligibility and Benefits (E&B) Verification feature in the zHealth software allows practices to check a patient's insurance coverage, plan status, and benefit details before services are rendered. This feature helps reduce claim denials, ...
Setting up Insurance Billing for Group vs Individual
This article provides guidance on configuring settings to ensure the appropriate population of either the group NPI or individual NPI in Box #33a of the CMS-1500 form. <span class="size" ...
Guidelines for Billing BCBS Illinois (HCSC) and Blue Shield of California
According to the Office Ally notification dated 01/13/2025, when submitting claims to the following two payers, the "Service Facility Information" on HCFA/UB claims does not require the Service Facility NPI if it is the same as the Billing Provider ...
Payer Enrollment for Benefit Verifications
Overview Some insurance payers mandate that a practice or provider be formally enrolled or credentialed with them before any electronic transactions, including Eligibility & Benefits (E&B) verification, can be processed. This is to ensure that the ...
Solution for Medicare denial for MSP(Medicare Secondary Payer)
MSP (Medicare Secondary Payer) refers to the process by which Medicare functions as the secondary payer, paying after another primary insurance has already paid its share of the claim. In simpler terms, when a person is covered by both Medicare and ...
How to Add or Edit Fee Schedules in Insurances
If you are in-network with an insurance company or you are just aware of what an insurance company agrees to pay for a particular procedural (billing) code, then you can use Maximum Allowed Rate to calculate patient responsibility as well as to make ...
Insurance Master List: Adding Insurance and Payer ID
Overview Insurances can be added to your existing insurance payer database in zHealthEHR. Once entered, the insurance company information can be directly fetched into the Health Insurance Claim Form when submitting claims. Insurance Configuration ...