6. Claims & Payment
Checklist for error-free claim submission
Avoid commonly missed or incorrectly completed claim steps by double-checking the items on this checklist:
Member or group number(double-check for accuracy, and include all numeric and alpha characters with no spaces).
Individual provider NPI number in field 24J.
Procedure codes billed with the incorrect units of service.
Correct combinations of field 24E and field 21 (diagnosis fields on CMS 1500 form).
All surgical procedures for the same date of service combined on a single claim.
Spelling of the patient's name; submit exactly the way it appears on their UCare ID card, and double-check the date of birth
Use the correct bill type (see Adjustment section of this chapter)