Provider-Based Physician Services Providers may retain physicians on a full-time or part-time basis in, for example, the fields of pathology, psychiatry, anesthesiology, and radiology, and in many instances (especially in teaching hospitals) in other fields of medical specialization as well. Any one of these physicians may be engaged in a variety of activities including teaching, […]
Receiving accurate insurance reimbursement for delivered services is always been a challenge for healthcare providers. Practice owners spend most of the time and energy on doing administrative tasks of medical billing to receive sufficient insurance reimbursements to cover overhead expenses and provide quality care. But often they make this task even harder by doing sloppy […]
Outsourcing your revenue cycle operations to a medical billing company is the right move toward securing the financial stability of your practice. But choosing any medical billing company could cost more headaches than benefits. Medical Billers and Coders is a leading medical billing company providing complete medical billing and coding services. While interacting with our […]
In the Final Medicare Physician Fee Schedule (MPFS) for 2022 issued on November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) added five new CPT codes in the categories of Chronic Care Management (CCM) and Principal Care Management (PCM) and increased reimbursement for already existing codes in the same categories. These codes are […]
Understanding False Claims Act As a healthcare practice, you can typically submit claims to Medicare or Medicaid. Your claims are bills for goods you provide and services you conduct for patients. These federal health insurance programs cover the costs associated with your services. The False Claim Act is a federal law that makes it a […]
Physician Self-Referral Law (Stark Law) Basics The Physician Self-Referral Law, commonly referred to as the Stark law, prohibits physicians from referring patients to receive Designated Health Services (DHS) payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship unless an exception applies. Financial relationships include […]
A/R Follow-up in Medical Billing Medical billing is a complicated process that requires special skills in medical billing, coding, denial, and AR management from experienced and well-trained staff. The financial health and success of any medical practice are dependent on maintaining positive cash flow. In order to provide patient care and cover expenses, it’s important […]
Basics of ‘No Surprises Act’ The ‘No Surprises Act’ provides patients with protection from surprise medical bills under certain circumstances. The ‘No Surprises Act’ part of the Consolidated Appropriations Act of 2021, forbids patients from receiving surprise medical bills when seeking emergency services or certain services from out-of-network providers at in-network facilities. The Act holds […]
As a healthcare provider, during your residency, you probably are not focused on who pays for your patients’ care. Once you start practicing, it is important to understand who the payers are. The U.S. health care system relies heavily on third-party payers, and, therefore, your patients often are not the ones who pay most of […]
On 19th May 2022, the American Medical Association (AMA) announced an update to Current Procedural Terminology (CPT®) including new product and administration codes assigned to the Moderna COVID-19 vaccine for children 6 months through 5 years old. While the Moderna COVID-19 vaccine for young children has yet to receive FDA authorization, AMA has created a […]