Medicare requirements for ambulance transport medical billing

Today various private and public ambulance transport services are operating in a huge number for servicing critical patients at crucial moments. These players are getting reimbursed under Medicare Part B which covers ambulance transport medical billing with certain limitations. Let’s understand Medicare Part B in more detail: Medicare Part B Medicare Part B covers emergency […]

Non-ST elevation (NSTEMI) ICD-10 Codes for Myocardial Infarction

NSTEMI, Type 1 vs Type 2 MI: Why Accurate ICD-10 Coding Directly Impacts Revenue and Compliance Myocardial infarction (MI) documentation errors are no longer just clinical inaccuracies. In today’s reimbursement environment, misclassifying Type 1 MI, Type 2 MI, or demand ischemia can materially impact DRG assignment, severity of illness, quality metrics, and audit exposure. Yet […]

Common challenges facing by physicians in 2021

Today physicians whether they own their practice or are employed by a hospital or larger health system are facing many challenges in the day-to-day routine. These common challenges include “How to use the EMR efficiently and getting paid”, overburden with administrative requirements, staffing, burnout, etc. despite their devotion to the practice of medicine and the […]

Billing Medicare for Assistant at Surgery

An Assistant at Surgery is a provider who actively assists the physician in charge of a case in performing a surgical procedure. A physician, nurse practitioner, physician assistant, or clinical nurse specialist who is authorized to provide such services under state law can serve as a surgery. Medicare considers advanced registered nurse practitioners (ARNP), physician […]

Avoiding Medicare/Medicaid Crossover Claims Rejections

If your Medicaid crossover claims are rejecting it may be due to the address you have on file with Medicare and Medicaid. When Medicare crosses over your claim to Medicaid, address fields like Master address and Pay-to (or remit address) are submitted. If Medicaid does not have the same addresses in their file, Medicaid will […]

Updates to the IRF Quality Reporting Program

CMS recently announced the proposed rules for the ‘Inpatient Psychiatric Facility Prospective Payment System and Inpatient Rehabilitation Facility Prospective Payment System’ for FY 2022. This proposed rule would update the prospective payment rates for IRFs for Federal FY 2022. The proposed FY 2022 IRF Prospective Payment System rule would boost Medicare payments by 1.8%, or […]

Avoid healthcare fraud by improving the medical billing process

In the US, providers are struggling daily basis with healthcare frauds. These frauds generally cost the healthcare industry 3 to 15 percent of the total expenditure in the United States hence healthcare fraud and abuse must be critical. What are healthcare fraud and abuse? Generally, fraud and abuse are referred to describe a range of […]

E/M Time-Based Coding

The physician or other qualified healthcare professional are using CPT codes from the range 99202-99499 which is called Evaluation and management (E/M) codes to represent services offered by physicians. These codes are applicable while evaluating and managing patient health. These (E/M) codes have been around for many years still reporting timed-based services is confusing. So let’s […]

How to Encourage Patients to Use Patient Portals?

A patient portal is a website which offers patients convenient, 24 by 7 access to personal health information irrespective geographic location with an Internet connection. Patient portals have various features like patients can conveniently access appointment requests, get to know the authentic information about diseases, etc. This portals save patient’s time and encourage ongoing participation in […]

ASC- The promising avenues for improving the delivery of health care

Ambulatory Surgical Centers brought a revolution in surgical care, enabling affordable, safe outpatient surgery. Moreover, the ASC industry is ahead of the curve in identifying avenues to improve health care delivery. ASCs are a rare example of a successful transformation in healthcare delivery. Hence, stakeholders must understand ASCs and their benefits and growth factors: For […]

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