Seoul Medical Group
5000 Airport Plaza Drive, Suite 150
Long Beach, CA, 90815-1260
Internet
https://WWW.AMM.CC
(Click to select IPA Website)
Fax
(562) 766-2007
Clearinghouse
Office Ally – Payer ID # AMM07
Capario – Payer ID # SMG01
To expedite processing, all claims submitted must be complete according to Federal and State of California guidelines.
Section 1300.71 (a)(2)(B)(i)(ii)
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the completed UB92 data set or its successor format adopted by the National Uniform Billing Committee (NUBC), submitted on the designated paper or electronic format as adopted by the NUBC;
entries stated as mandatory by NUBC and required by federal statute and regulations; and any state-designated data requirements included in statutes or regulations.
Section 1300.71 (a)(2)(D)(i)
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the Centers for Medicare and Medicaid Services (CMS) Form 1500 or its successor adopted by the National Uniform Claim Committee (NUCC) submitted on the designated paper or electronic format.
Part 424 Subpart C Section 424.30 through 424.40
Must be on UB92 claim form.
Must be on CMS 1500 claim form
Can’t submit more than six lines of service on one claim
For referred and/or ordered Services the name of the referring or ordering physician and the NPI or UPIN numbers must be present in box 17 and 17A
Section 1300.71 (a)(2)(D)(ii)
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Current Procedural Terminology (CPT) codes and modifiers and International Classification of Diseases (ICD-9CM) codes;
Section 1300.71(a)(2)(D)(iii)
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Entries stated as mandatory by NUCC and required by federal statute and regulations; and any statedesignated data requirements included in statutes or regulations
Part 424 Subpart C Section 424.32 (1), Section 424.32 (2), and Section 424.34 (4)
Must have appropriate coding
CPT Level I codes
Appropriate CPT and/or HCPCS modifiers
HCPCS National Level II Codes
HCPCS Local Level III Codes
ICD-9-CM
Medicare requires that all claims contain codes for patient diagnoses and for procedures provided.