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li7tnnrur f,irtdrpri.c~~s. I.LC <br />.1si~nment :~utharization <br />ln;!udt:d on .III in~~ilices and ;rltementc Inaileti out b~- \~'ittman Lrterprises. LLC for the Cite is <br />:~~~ .I;~i~,nnlcnt of benetit autl~IOriiati~~n that is mandator~~ for \9edicare billing. I1~ the :i~nattlre is <br />n~~t r~btained at the time of service b_ the field cre~~s. uc ~tiill relea,e the in~~oice to the patient <br />~h'.' ~~.~InplClti)n. 11 1~ llllpi7rtailt it) nl~tt' that I'e~t.'asc o~ bl~~lnf! IO ~,]«h~~ll'C 1~ nC~l pCRIlliIC(.~ ~~1thOUI <br />the ~3~'Ila1t11'e i1t lh:' p'a11eI1L deS1~~IlalCd ~?UBCC~Iiin Uf v~7llle~~ll IItC11I1'.3llt?n 1h:I1 Iht: ~latti[Ilt IS Ilt~l <br />,.1~1: ', c, ;i;~n. It~ ;he (icf~i cI'e~~~ :Ire nt~t rec~tlircd to t~htain the i,,n.ItIII't: or ~.~itne~~ the patient- <br />I:i,1l`I':lt`. t~~ ~i~I; at llnl'.' i~~ ~~1't~IC~. U111111~ ill1~~ 1~7C1'C~1111 ~?i11I1?Cn1 ~~I~~ bC Si ~`11t1~aIlllV ~~~]~A~~~i, <br />?.1.Z-x.1.5 B11_LI~(; Fl~1C"h[U\S, Rh:COIZU ~I:~I1~TI:A:1\('I~:, 1'Htllll 1':1R'll~ <br />('L,V ~I, :~1I) CliOSS IZEE'I~:RI?\C'l~: OI~ 1':1'fll~:ti-1' :~000l ~-Tti <br />~ut~plies and Equipment <br />\~~rl~aan C:nicrprises. I.LC provides all supplies. ec}uipment. and se:r~~ices neccssu"~ to perform <br />I;1: t1'~ ;~JOil~ ~): the 1~~ 1' aI ilU addltli~llal cU~t It? IIIe ~~lt~. ~Up(?IIe~. e~lUlplne111. and sei'V'1cC~ <br />Iil: ~U~.l~ ''Ill :31.e nl~i lllllited tl~' <br />• :~Il eoll](lUlCl' hal'd\\aCC atld CottVV~a!'C IIcCeSSaI'~ Itl I?extol"m aCeUCalel\ anal etflClentlV~ the <br />~~roresses as described in this IZI~N - - <br />• ~~ll 111,1I11n!~ ti'i'ill.ti. hl~lli?`~ !oi'[I1S. III~UraI1Ce foi"I?l~, ilen tol'm~, Gild ell~elopC> Il:'l'C~sart to <br />'eI'IOI'll? the billlll~ tnllltlQll~ <br />• 1n~~ prlstage neccssar~ to mail l'~illin,~ or information to patients. insurance companies. <br />?rd }?arties, iuld attorney s <br />• \~~Ii'abilit~ ~,1~ CI national tali i-ree S(}0 number for patient>. the Cite, insurance <br />c~.?Inpani<,. uttorne~ ~ ,' paI-ties to call for information or discussion ofaecount status <br />h:lectronic Killing of C'laimti <br />~~s .~ matter rt' ctnu"sc. 1~~itnnar, f:ntcrpriscs. LLC electronicall.. hi11 the ('it~-> \ledicare and <br />~1cd;-Cal claim; resultin in p,nlnrnt in 1-l da~~s iuld ., dais respecti~eJ~. ('alifornia is unique in <br />its munber of~ ~leaicare and ~icdi-Cal ] i\1O pa~~ers. Vl'hen ~~e recei~~e a trip indicating 'Medicare <br />i)r \Iedi-Cal cu~cra~ac. ~~e ~erit~~ this infilnllation throu~,h rizctrunic ~eriticatilm ;~"stcma in order <br />t~l he certain ~,~'hillin~~ corrcrtl~. the first time. ~hhesc claims are transmitted tiai;~ usin~~ :1\SI, the <br />forlllat s.t f~~I"th under the EIII'_1.1 rettuirements. <br />Cin• o/ Smrla Ana Firr Drpurbnrrrr <br />25C-13 <br />