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Buy and Bill Guide
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Introduction to Buy-and-Bill
Step-by-Step
Who Holds the Risk?
Role of the Provider
Role of the Payer
Prior to Drug Administration
Distribution and Inventory
Patient Scheduling
Obtaining Insurance Verification
Obtaining Prior Authorization
Documentation of Drugs and Drug Administration
Coding
Coding Systems
HCPCS Coding with an established HCPCS
HCPCS Coding without an established HCPCS
ICD-10-CM
CPT Coding in Drug Administration
Coding By Setting
Coding Modifiers with Examples
Billing for Non-Physician Practitioners
Claim Submission
Form CMS-1450 (UB-O4)
Form CMS-1500
Denials and Appeals
focalPoint Data
Appeals Under Medicare
Writing a Quality Appeal
Medicare Regulations
Medicare Benefit Policy Manual
National Coverage Determinations
Claims Processing Manual
Additional Tools and Resources A-Z
CARC/RARC Report – Practice Actions
References
The People’s Guide to Buy and Bill
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