Orthopedic surgeons are increasingly incorporating physical and occupational therapy services into their practices. In-house billers, who may be inexperienced with the new services, terminology, and associated CPT codes, may be unsure about billing for therapy care. Medical Billers and Coders (MBC) is a leading medical billing company providing complete revenue cycle services. We keep on […]
January 1, 2017, onwards Medicare provided coverage for cognitive assessment and care plan services. Reimbursement requires cognition-focused evaluation, identification of caregivers and caregiver needs, and development, revision, or review of an Advance Care Plan. Effective January 1, 2022, Medicare increased payment for these services to $282 (it will get geographically adjusted) when provided in an […]
Many practitioners have difficulty being paid for Transitional Care Management (TCM) services. In many cases, claims submitted for TCM services have not been paid due to several common errors in claim submission. In particular, the practitioner should ensure that the entire 30-day TCM service was furnished, the service began with a qualified discharge from a […]
One of the common reasons medical claims may be denied is for missing modifiers or invalid modifier combinations. Accurate coding of treatment is essential, but it’s also important to ensure you include modifiers when necessary and ensure you’ve used the correct one for the code you’re using. When your claim is denied, it not only […]
Government and private payers conduct audits to find out fraudulent or abusive medical billing practices. As a provider, you deserve to be paid accurately for the medical care you provide. At the same time, it’s essential that you avoid improper billing practices to steer clear of trouble and maintain a flourishing practice. In this article, […]
The decision to close or relocate a medical practice can be a difficult one, with consequences for patients as well as for the departing physician’s colleagues. Physician practices close or relocate for many reasons, including practice solo, joining another group, relocating, a decision to sell, retire, physician illness, due to the COVID-19 pandemic. Whether you […]
With more patients opting for High Deductible Health Plans (HDHP), the total percentage of patient payments has increased significantly in the last few years. A recent survey report regarding healthcare payment patterns reveals that about 35 percent of provider revenue comes from patient pay. Timely collection of patient payments is the key to the financial […]
The most important reason for retaining medical records is to share information on a patient’s care with other healthcare professionals. The COVID-19 pandemic and increased inpatient telehealth services have emphasized the importance of retaining complete and accurate records. Retaining well-maintained patient records helps medical professionals ensure continuity of care and protect against any future professional […]
It is not uncommon for radiologists to receive inadequate patient information that potentially compromises their diagnostic decision-making abilities and accuracy. The recent evidence-based study has shown that communication of clinical information to the radiologist, including patient complaints and indications for the imaging request, is required for a quality radiology interpretation process and for making recommendations. […]
Documentation requirements for telehealthcare are identical to those of onsite medical care. Documentation plays a significant role in establishing medical necessity for billing; adhering to regulatory compliance; and supporting your claim in case of internal and external audits. Documentation rules may change as per insurance carrier’s contracts outlining medical necessity expectations and state regulations that […]
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