Remark code M124 indicates a missing declaration on whether the patient owns the equipment needing the part or supply.
Remark code M124 indicates that there is missing information regarding the ownership of the equipment for which a part or supply is needed. The billing party must specify whether the patient owns the equipment to process the claim properly.
Common causes of code M124 are situations where the billing information submitted to the insurance payer lacks clear documentation indicating ownership of durable medical equipment (DME) or other medical supplies. This can occur when:
1. The healthcare provider fails to specify on the claim form that the patient owns the equipment for which parts or supplies are being billed.
2. There is an oversight in the electronic health records or billing system where the ownership details are not properly recorded or transmitted.
3. The documentation provided to the payer does not include proof of purchase or other evidence that the patient has purchased and owns the equipment.
4. The claim is submitted with incomplete information, and the section detailing equipment ownership is left blank or is ambiguous.
5. There is a misunderstanding or miscommunication between the healthcare provider and the patient regarding the ownership status of the equipment, leading to incorrect or missing information on the claim.
Addressing these issues requires thorough verification of the patient's ownership of the equipment before claim submission and ensuring that all necessary documentation is accurately reflected and included with the claim.
Ways to mitigate code M124 include implementing a thorough review process for all durable medical equipment (DME) claims to ensure that ownership information is clearly documented. Staff should be trained to verify and record whether the patient owns the equipment in question during the intake process. Additionally, incorporating a checklist for DME claims can help ensure that all necessary information, including patient equipment ownership, is captured before submission. Regular audits of DME claims can also identify patterns of missing information and lead to process improvements to prevent this issue from recurring.
The steps to address code M124 involve verifying the patient's equipment ownership status. Begin by reviewing the patient's file and any previous claims to determine if the ownership information is documented. If the information is not present, reach out to the patient or the patient's representative to confirm whether they own the equipment in question. Once ownership is established, update the claim with the appropriate indicator for equipment ownership. Resubmit the corrected claim to the payer, ensuring that all other claim details are accurate and complete to avoid further delays in processing. Keep a record of the communication and changes made to the claim for future reference and compliance.
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