Claims & Billing
Explore claims and billing resources, including filing requirements, payment guidelines, and coverage information.
After-Hours Codes
Access guidance on after-hours CPT codes, including billing requirements, covered services, and reimbursement information for eligible visits.
Akamai Advantage Plans Coverage for Dental Services Inextricably Linked to Covered Medical Services
Learn about Akamai Advantage coverage for dental services linked to covered medical care, including eligibility, coverage criteria, and billing guidelines.
Akamai Advantage Routine Hearing Exam and Hearing Aid – Claim Submission Guidelines
Learn about Akamai Advantage routine hearing exam and hearing aid claim submission guidelines, including coverage, billing requirements, and claims processing.
All Patient Refined Diagnosis Related Groups (APR-DRG) Overview
Learn about MQD QI All Patients Refined Diagnosis Related Groups (APR-DRGs), including classification methods, reimbursement, and payment guidelines.
Anesthesia for Labor and Delivery
Guidelines for anesthesia services during labor and delivery, including coding, CPT codes, modifiers, and billing requirements for obstetric anesthesia.
Anesthesia Procedures – Claim Documentation Requirements
Guidelines for anesthesia procedure claim documentation, including clinical notes, pre-anesthesia evaluations, and reporting requirements for high-risk patients.
Anesthesia Services – Claim Documentation Requirements
Guidelines for anesthesia service claim documentation, including clinical records, required documentation, and criteria to support medical necessity and reimbursement.
Basic Claims Filing - The CMS 1500 Claim Form
Learn how to properly complete and submit the CMS-1500 claim form, including required fields, billing guidelines, and claims filing best practices.
Billing for Deluxe Intraocular Lens (IOL) - Private Business
Learn how to bill for deluxe intraocular lenses (IOLs), including correct HCPCS codes, claim form requirements, and patient cost responsibilities under HMSA private business guidelines.
Billing for DME
Learn HMSA requirements for billing durable medical equipment (DME), including HCPCS codes, modifiers, and documentation needed for accurate claims submission.