Insurance
What are the billing codes and how do I bill Med-Pay/PIP?
Organization ApprovedSource Verified
Summary
Every patient is assigned a Billing Code once all insurance is verified; the code determines how the account is billed. Initial billing goes out as soon as HICFAs are received, and weekly billing is printed and faxed each Monday.
- 1Assign a Billing Code once all sources of insurance have been verified — the code determines how the account will be billed.
- 2Codes: A = Unassigned (still verifying); 1 = Write-Offs; 2 = Collections; 3 = Professional Courtesy (PC); 4 = Phil Votaw accounts; 5 = Med-Pay/PIP; 6 = Personal Injury with Attorney; 7 = Personal Injury, no attorney/3rd party only; 9 = Coverage pending.
- 3Patients examined with no charges due to non-sufficient findings (NSF) are billing code 3; handle the account like any other patient, but change the NP exam charge to zero in Medisoft and provide no other services.
- 4Initial billing — as soon as HICFAs are received, pull the chart, copy the Assignment of Benefits/Power of Attorney, and return the original to the chart.
- 5On the copy, write the claim number and carrier name; it is submitted with the HICFAs.
- 6Copy the Confidential Patient Information, all pages of the Travel Card, and the x-ray report.
- 7Email the HICFAs, AOB/POA, CPI, Travel Card, and x-ray report to the 1st party carrier and 1st adjuster contact, cc the clinic collector, document billing in Medisoft, and file the HICFAs on the left side of the chart.
- 8Weekly billing — print and fax billing each Monday after the initial billing so payment is received timely.
- 9Copy the Travel Card only for the dates of service in the applicable billing cycle, including both Exam pages for any RE visits.
- 10Email the HICFAs and Travel Card to the same carrier/adjuster contact, cc the clinic collector, document in Medisoft, and file the HICFAs on the left side of the chart.
Citation
CA Manual, Billing Codes; Billing Procedures (Med-Pay/PIP), p. Insurance/Billing · Revised 2/9/26Answers source the CA Manual first; the Medisoft guide is used only where the CA Manual does not cover the task.