The high level of spending on healthcare in the United States has been under increasing scrutiny for a long time. The realization that growth in health care spending in the US has outpaced growth in inflation, population, and GDP has intensified the concern of the federal government, providers, healthcare consumers, and payers. The lack of […]
Medicare Coverage for Wound Care: Medicare covers wound care for all beneficiaries, irrespective of whether it is carried out in an inpatient or outpatient setting. It can be expensive for patients. Few people may suffer from post-surgical lesions. Other patients may suffer from chronic fungal or viral wounds. Due to the prevalence of wounds with […]
Provider insurance credentialing is a complex and time-consuming process. Once you have decided to start the credentialing process, your first task would be knowing key payers to get credentialed with. Your second task would be listing payers who are difficult to get credentialed with. For some payers, the credentialing process is much more complex compared […]
To overcome the financial impact of pandemic, providers need to measure and focus on an efficient RCM process to get success in 2021. COVID-19 pandemic has a severe impact on the healthcare industry, caused healthcare providers to depend on efficient RCM process to maintain financial stability in 2021 and henceforth. What is RCM Process? Revenue […]
Medical Credentialing is the process of requesting to participate in a health insurance provider network – or to be contracted with the insurer. Healthcare providers have to apply to and must be accepted by the insurance company. It is necessary to qualify for benefits and to be associated with or a “network provider” for that insurance carrier. […]
PECOS is the short form for Provider, Enrollment, Chain, and Ownership System. It is a database where doctors register with the Centers for Medicare and Medicaid Services (CMS). It is a national electronic database for recording and retaining data on Medicare-enrolled providers and suppliers. CMS developed PECOS as a mechanism to combat fraud and abuse. PECOS […]
As medical credentialing enables the patients to confidently trust their chosen healthcare providers, it has become very crucial. A medical practitioner cannot work at a hospital legally or partner with insurers, without proper medical credentialing. Only a new physician or practitioner who is credentialed is allowed to see patients, treat hospital inpatients, and receive insurance […]
Loss of Protective Sensation (LOPS) Basics Diabetic sensory neuropathy, or peripheral neuropathy, is the most common factor leading to amputation in people with diabetes. In diabetes, sensory neuropathy is an anatomically diffuse process primarily affecting autonomic and sensory fibers; however, distal motor findings may be present in advanced cases. Long nerves are affected first, with […]
Replacing Code 0249T CPT Category III code 0249T, ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance, has been deleted and converted to CPT Category I code 46948, hemorrhoidectomy, internal, by Code for Transanal Hemorrhoidal Dearterialization (THD), 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed. The new code, CPT 46948, more accurately describes […]
On 19th Jan 2020, the American Medical Association (AMA) added new CPT codes (91302 and 0031A) for Janssen COVID-19 Vaccine, a division of Johnson & Johnson. Janssen is a single-dose COVID-19 vaccine which is 4th vaccine to get unique CPT codes for documentation and billing. The new CPT codes will be effective for use on […]
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