Healthcare providers focus on providing high-quality, equitable, and safe care as patient care and patient satisfaction are the ultimate motives for running practice. Patient billing is an important part of the care experience, where most practices face challenges day-to-day basis. Most of the surveys focusing on patient satisfaction report that patient bills can be difficult […]
During the COVID-19 pandemic, mandatory social distancing and the lack of effective treatments have made telemedicine the safest interactive system between patients and providers. Government authorities dramatically expanded telemedicine access during the pandemic. But as COVID is ebbing away and public health emergencies (PHE) in many states are ending, how does it will impact telehealth […]
As an attempt to lower drug costs, the Centers for Medicare & Medicaid Services (CMS) released an interim final rule that implements a new payment model, known as the Most Favored Nation (MFN) Model. Its approach is to pay no more for high-cost Medicare Part B drugs and biologicals than the lowest price that drug […]
It’s quite common for healthcare providers to outsource their billing activities to a medical billing company. Billing and coding for various medical specialties are challenging tasks due to billing guidelines, payer reimbursement policies, updated ICD-10 codes, and accurate use of procedure codes & modifiers. An orthopedic surgeon recently remarked that he was thinking about outsourcing […]
CMS recently proposed a rule to improve prior authorization processes by reducing the burden on providers and patients. This proposed rule would place new requirements on Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs, and Qualified Health Plans (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of […]
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, […]
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