On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule which was implemented on February 28, 2022. This final rule addressed the classification and payment of continuous glucose monitor (CGMs) under the Medicare Part B benefit for durable medical equipment (DME). This rule expanded the classification of DME to […]
The Centers for Medicare & Medicaid Services (CMS) every year releases the Medicare Physician Fee Schedule (MPFS) to announce policy changes. In this blog, we shared important coding updates for the year 2022, applicable to urgent care services. Reduced Conversion Factor The Protecting Medicare and American Farmers from Sequester Cuts Act were signed into law […]
Electronic Data Interchange (EDI) represents a digital communication channel to deliver data from payers to providers digitally and securely. Most of the providers have a lot of confusion over what it meant by EDI or ERA enrollment. EDI simplifies the process of sending information back and forth between provider and insurance carrier. If you want […]
When you submit a claim to any insurance carrier, it will either get paid, fully or partially, or it might get rejected or it might get denied. Most of the time, providers get confused between claim rejection and claim denial. When a claim is rejected, it generally means details mentioned in the claim are either […]
Providers continue to wonder how we can live in a world where so many RCM processes are handled quickly with technology, yet decisions that affect patient health are slowed by faxes and bureaucracy, even when there is only one clear treatment option. Yes, you are right, we are talking about Prior Authorization (PA) or Pre-Auth. […]
Medical billing which is part of Revenue Cycle Management represents all activities resulting in receiving accurate payment for services rendered to a patient. Medical billing and coding require specialized knowledge and specific skills which can’t be always handled by providers. There are a number of pieces to the puzzle that go from patients visiting your […]
Multiple E&M visits on the same day for the same patient address instances when a physician(s) or other qualified health care professional(s) reports a single code for multiple medical and/or Evaluation and Management (E/M) services for a patient on a single date of service. Multiple E/M Visits: General E/M Code Procedure Generally, a single E/M […]
Collecting from patients is one of the more challenging tasks of practice management. For the financial sustainability of your practice, you must make a concerted effort to collect co-payments, coinsurance, deductibles, and amounts for services not covered by insurance. You will receive more patient collections if you try and collect at the time of service […]
Telemedicine and telehealth services were growing before the COVID-19 pandemic, and demand has soared during the pandemic as patients and providers alike recognized the efficiencies and convenience of delivering care remotely. However, along with the surge in demand for virtual care comes a higher risk of a malpractice claim for health care professionals. In this […]
Increasing Number of Malpractice Suits For many providers, it’s not a matter of if they will be sued at some point in their career, but when it will happen. It’s quite a common occurrence in today’s society, to a doctor for a poor health outcome, even when the provider has done nothing wrong. You will […]
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