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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    • TESTIMONIALS BY STATE
      • AK, AL, AR & AZ
      • CA, CN, CO & DC
      • DE, FL, GA & HI
      • IA, ID, IL & IN
      • KS, KY, LA, MA & MD
      • ME, MI, MN, MO
      • MS, MT, NC & ND
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FREE DOCUMENTS - Global fee, HIPAA & Other G

GASTROENTEROLOGY SUPERBILL (pdf)
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GENERAL EXAM PROGRESS NOTE (pdf)
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GENERAL PRACTICE SUPERBILL (doc)
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GLOBAL FEE PERIODS - 2018 MEDICARE (pdf)
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GPO PRICING (pdf)
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FREE DOCUMENTS - HIPPA, HRA & OTHER H

HARDSHIP APPLICATION (doc)
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HARDSHIP WAIVER MEDICARE (doc)
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HEALTH RISK ASSESSMENT FORM - 2018 (docx)
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HEALTH RISK ASSESSMENT FORM - 2018 (pdf)
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HARDSHIP WAIVER MEDICARE (doc)
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HIPAA BAA Incorporating Omnibus Rule Changes (docx)
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HIPAA COMPLIANCE 101 (pdf)
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HIPAA CONFIDENTIALITY AGREEMENT (doc)
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HIPAA FAX COVER -HUMOROUS (doc)
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HIPAA FAX COVER SHEET (doc)
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HIPAA NPP EXAMPLE (doc)
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HIPAA NPP-Spanish (doc)
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H-R-A FORM (docx)
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HIPAA BAA Incorporating Omnibus Rule Changes (docx)
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HIPAA SUMMARY (doc)
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HIPAA-NPP-SAMPLE (doc)
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HISTORY OF PRESENT ILLNESS FORM (doc)
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HOMEBOUND PATIENT RULES (doc)
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HOSPITAL CUTBACKS MEMO (doc)
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HOSPITAL OUTPATIENT OR CLINIC RULES (txt)
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HPI DISCUSSION (pdf)
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HRA-EXAMPLE (pdf)
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FREE DOCUMENTS - ICD-10, INTERNAL, OTHER I

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

LAB FEE SCHEDULE 2018 (pdf)
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LAB-NCD-MEDICARE (pdf)
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LOCALITY-ZIP5_JAN18 (pdf)
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FREE DOCUMENTS - MEDICARE 855 & OTHER M

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

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

NERVE CONDUCTION STUDIES - MEDICARE (doc)
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NEURO SURGICAL SUPERBILL (doc)
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NEW PATIENT DEFINITION (doc)
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NEW PATIENT HISTORY FORM (doc)
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FREE DOCUMENTS - OP NOTES & OTHER O

OB GYN GUIDE (doc)
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OBSTETRICS SUPERBILL (doc)
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OP NOTES TEST ANSWERS (doc)
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OP NOTES TEST (doc)
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Orthopedic Superbill (pdf)
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OUT PATIENT BILLING GUIDELINES (tif)
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  • Home
  • SHOP
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  • COGNITIVE
  • E&M SLIDERULE
  • ERISA
  • FREE DOCUMENTS
  • _Superbills
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