Medical Reimbursement Consultants since 1988, serving tens of thousands of physicians

Don Self and Assoc. Inc.
Don Self and Assoc. Inc.
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FREE DOCUMENTS - Global fee, HIPAA & Other G

GASTROENTEROLOGY SUPERBILL (pdf)Download
GENERAL EXAM PROGRESS NOTE (pdf)Download
GENERAL PRACTICE SUPERBILL (doc)Download
GLOBAL FEE PERIODS - 2018 MEDICARE (pdf)Download
GPO PRICING (pdf)Download

FREE DOCUMENTS - HIPPA, HRA & OTHER H

HARDSHIP APPLICATION (doc)Download
Hardship Medicare Financial Application (pdf)Download
HARDSHIP WAIVER MEDICARE (doc)Download
HARDSHIP WAIVER MEDICARE (doc)Download
HEALTH RISK ASSESSMENT FORM - 2018 (docx)Download
HEALTH RISK ASSESSMENT FORM - 2018 (pdf)Download
HIPAA BAA Incorporating Omnibus Rule Changes (docx)Download
HIPAA COMPLIANCE 101 (pdf)Download
HIPAA CONFIDENTIALITY AGREEMENT (doc)Download
HIPAA FAX COVER -HUMOROUS (doc)Download
HIPAA FAX COVER SHEET (doc)Download
HIPAA NPP EXAMPLE (doc)Download
HIPAA NPP-Spanish (doc)Download
H-R-A FORM (docx)Download
HIPAA BAA Incorporating Omnibus Rule Changes (docx)Download
HIPAA SUMMARY (doc)Download
HIPAA-NPP-SAMPLE (doc)Download
HISTORY OF PRESENT ILLNESS FORM (doc)Download
HOMEBOUND PATIENT RULES (doc)Download
HOSPITAL CUTBACKS MEMO (doc)Download
HOSPITAL OUTPATIENT OR CLINIC RULES (txt)Download
HPI DISCUSSION (pdf)Download
HRA-EXAMPLE (pdf)Download

FREE DOCUMENTS - ICD-10, INTERNAL, OTHER I

ICD-10 GUIDE FOR GENERAL SURGERY (pdf)Download
ICD-10 GUIDE FOR OB:GYN (pdf)Download
ICD-10 GUIDE FOR OPHTHALMOLOGY (pdf)Download
ICD-10 GUIDE FOR RADIATION ONCOLOGY (pdf)Download
ICD-10-Codes (pdf)Download
ICD-10-for-ER (pdf)Download
INFUSION SUPERBILL (pdf)Download
INSURANCE ONLY DANGER (doc)Download
INTERNAL MEDICINE SUPERBILL-INPT (pdf)Download
INTERNAL MEDICINE SUPERBILL (pdf)Download
INSURANCE WITHDRAWAL LETTER TO PATIENTS (doc)Download

FREE DOCUMENTS - LAB NCD & OTHER L

LAB FEE SCHEDULE 2018 (pdf)Download
LAB-NCD-MEDICARE (pdf)Download
LOCALITY-ZIP5_JAN18 (pdf)Download

FREE DOCUMENTS - MEDICARE 855 & OTHER M

MANAGED CARE CONTRACTING TIPS (doc)Download
MEDICAL RECORDS TRANSFER GUIDE (doc)Download
Medicare 2018 Util Per Specialty (xlsx)Download
MEDICARE 855A FORM (pdf)Download
MEDICARE 855B FORM (pdf)Download
MEDICARE 855I FORM (pdf)Download
MEDICARE 855R FORM (pdf)Download
MEDICARE 855S FORM (pdf)Download
MEDICARE FAMILY MEMBERS (doc)Download
MEDICARE HIN SUFFIXES (doc)Download
MEDICARE LAB FEE SCHEDULE 2018 (pdf)Download
MEDICARE PC-TC (pdf)Download
MEDICARE REMARK CODES (pdf)Download
MEDICARE REMITTANCE CODES (pdf)Download
Medicare Specialty Codes-2018 (pdf)Download

MODIFIERS & OTHER M CONTINUED

MEDICARE STATUS CODES (doc)Download
Medicare-ADL (doc)Download
Medicare-ADL (pdf)Download
MEDICRE ABN BOOKLET (pdf)Download
MODIFIER 25 APPEAL LETTER - ESTAB PATIENT (doc)Download
MODIFIER 25 APPEAL LETTER - NEW PATIENT (doc)Download
MODIFIER 25 (pdf)Download
MODIFIER 57 APPEAL LETTER (doc)Download
MODIFIER 59 (pdf)Download
MULTI-SPECIALTY PROGRESS NOTE (doc)Download

FREE DOCUMENTS - NEW PATIENT & OTHER N

NERVE CONDUCTION STUDIES - MEDICARE (doc)Download
NEURO SURGICAL SUPERBILL (doc)Download
NEW PATIENT DEFINITION (doc)Download
NEW PATIENT HISTORY FORM (doc)Download

FREE DOCUMENTS - OP NOTES & OTHER O

OB GYN GUIDE (doc)Download
OBSTETRICS SUPERBILL (doc)Download
OP NOTES TEST ANSWERS (doc)Download
OP NOTES TEST (doc)Download
Orthopedic Superbill (pdf)Download
OUT PATIENT BILLING GUIDELINES (tif)Download

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