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Medical Billing Services
Streamlining and Automating Prior Authorization
CMS’s Proposed Rule on Automating Prior Authorization On 10th December 2020, The Centers for Medicare & Medicaid Services (CMS) proposed a new regulation aimed at improving the sharing of healthcare data between payers and providers and streamlining prior authorization, a major administrative hassle for providers. This new rule will boost…
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Medical Billing Services
What is the Medicare Crossover Claim?
A crossover claim is a claim for a recipient who is eligible for both Medicare and Medicaid, where Medicare pays a portion of the claim, and Medicaid is billed for any remaining deductible and/or coinsurance. A Coordination of Benefits Contractor (COBC) is used to electronically, automatically cross over claims billed…
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Medical Billing Services
Outpatient E/M Revisions for 2021
The American Medical Association (AMA) and Centers for Medicare & Medicaid Services (CMS) has announced guideline and code descriptor changes for outpatient E/M services to be effective from Jan. 1, 2021. These changes will be applicable only to office or other outpatient E/M codes (99202-99215); all other E/M services will…
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Wound Care Billing Services
Coding for Open Fracture Debridement
Basics of Open Fracture Debridement Debridement is used to remove foreign material or damaged, dead, or contaminated tissue from a surgical field, wound, or injury. Debridement is used to promote healthy healing of damaged skin, tissue, muscle, or bone. The debridement of small amounts of devitalized or granulation tissue during…
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Medical Billing Services
How to Credential Your Practice with Vision Plan?
You just graduated from a school of optometry and decided your practice location. If you plan on examining patients who wish to use their vision and medical insurance, you must be an ‘in-network provider’ with that insurance company. According to the US Census Bureau, over 83 percent of the US…
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Medical Billing Services
Most Popular Payers to Get Credentialed with
Credentialing has become crucial for medical practices to survive in an increasingly volatile and competitive industry. Most American citizens today are covered by an insurance plan provided by some company or the other. If you fail to get credentialed with the insurance companies, then you will lose clients to your…
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Medical Billing Services
Billing for Worker’s Compensation
Basics of Worker’s Compensation Worker’s compensation, commonly known as worker’s comp, is a type of insurance that covers the treatment of injuries occurring on the job. Employers typically purchase commercial worker’s comp policies directly, although some states administer these policies. Medical billers must therefore remain aware of the worker’s comp…
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