
Get the free Health Plan Billing Guidance - Version 26 - NC Medicaid
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2. ATTACHMENT B, PROGRAM SERVICES AND UNIT RATES (JULY 2022), is deleted in its entirety and replaced with ATTACHMENT B, PROGRAM SERVICES AND UNIT RATES (OCTOBER 2022). 3. ATTACHMENT C, CONTRACT
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What is health plan billing guidance?
Health plan billing guidance refers to the regulations and instructions provided to assist health plans in properly billing for services and claims. It includes standards for documentation, coding, and the submission process to ensure compliance with healthcare laws.
Who is required to file health plan billing guidance?
Health insurance providers, including insurance companies, third-party administrators, and other entities that manage health plans are required to file health plan billing guidance.
How to fill out health plan billing guidance?
To fill out health plan billing guidance, entities must follow the provided templates or forms, ensuring accurate reporting of all required data such as member information, claim details, and necessary signatures. Ensuring compliance with the latest regulations is critical.
What is the purpose of health plan billing guidance?
The purpose of health plan billing guidance is to establish clear and consistent practices for billing and reporting to promote accuracy, reduce errors, and facilitate timely payments among health plans and healthcare providers.
What information must be reported on health plan billing guidance?
Information that must be reported includes the insured's details, claim numbers, dates of service, billed amounts, diagnoses, procedure codes, and any supporting documentation as required by regulatory entities.
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