The Federal Government Investigating COVID-19 Fraud

COVID-19 Fraud The federal government is broadening its multi-agency law enforcement effort to address pandemic-related fraud beyond Paycheck Protection Program (PPP) related cases to encompass alleged instances of healthcare-related COVID-19 fraud. The subjects and targets of these investigations and prosecutions include alleged bogus telemedicine encounters, falsifying COVID-19 vaccination cards, and the misuse of healthcare provider […]

Understanding Medicare TPE Audits

Medicare TPE audits: The Centers for Medicare & Medicaid Services (CMS) is resuming the Targeted Probe & Educate (TPE) audit, effective September 1, 2021. Based on data analysis of claims payment, CMS will identify areas with the greatest risk of inappropriate program payment. CMS’s Targeted Probe and Educate (TPE) program is designed to help providers […]

Medicare Coverage for Vagus Nerve Stimulation (VNS)

Vagus Nerve Stimulation (VNS) is a pulse generator, similar to a pacemaker, that is surgically implanted under the skin of the left chest and an electrical lead (wire) is connected from the generator to the left vagus nerve. Electrical signals are sent from the battery-powered generator to the vagus nerve via the lead. These signals […]

Practice Management Guidelines to Improve Practice Collections

Receiving accurate insurance reimbursement for delivered services is always been a challenge for healthcare providers. Practice owners spend most of their 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 […]

Choosing Desired Medical Billing Company for Your Practice

Outsourcing your revenue cycle operations to a medical billing company is the right move toward securing the financial stability of your practice. However, choosing any medical billing company could cause 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 […]

2022 Revised Codes for Principal Care Management

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 […]

Avoiding False Claim Billing for your Practice

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 […]

Avoiding Fraudulent Billing as a New Medical Practice

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. healthcare system relies heavily on third-party payers, and, therefore, your patients often are not the ones who pay most of their […]

Newly Added Moderna COVID-19 Vaccine Codes for Children

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 […]

Communication Channels for Telehealth During Extended COVID-19 PHE

Throughout the COVID-19 pandemic, CMS and government agencies provided flexibilities to healthcare companies to use popular technology and applications to better engage with their patients. One example is the Department of Health and Human Services’ Office of Civil Rights (OCR), which issued a notice that it will allow healthcare providers to use widely available communications […]

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