What is CAQH? Council for Affordable Quality Healthcare, Inc. (initialized as CAQH) is a non-profit organization incorporated in California as a mutual benefit corporation. It is essentially an online portal that stores provider information in a secure, collaboration database. This secured information is granted to health insurance companies during the credentialing process to make acquiring […]
Compliance guidelines that govern the Ambulatory Surgery Center’s reimbursement are wide-ranging, complex, and ever-changing. Hence, it’s important for ASCs to hire or partner with Ambulatory Surgery Center medical billing and coding management consultants who understand the legal rules placed on ASCs, including specialized coding, accreditation, documentation, and reimbursement care contracts. Here are Prominent Ambulatory Surgery […]
The Ambulatory Surgical Center (ASC) market has grown rapidly in recent years. As insurance limitations tighten and health costs rise, more and more people are turning to outpatient facilities for high-quality surgery at affordable rates. Outsourcing your ASC medical billing and coding helps you address many of your financial concerns and increases profitability. But recent […]
Every moment when you think that your optometry billing and coding prerequisites are under control, new reimbursement and claims submission guidelines, coding alerts, or dedicated staffing roadblocks occur. When you as a practitioner are continuously managing claim denials and rejections, along with eligibility and benefits verifications, plus the claims submission and payment posting, looking into […]
Modifier 25 is used when a minor procedure (one with a 0- or 10-day global period) and a significant and separately identifiable evaluation and management (E/M) service are performed during the same session or day. Modifier 25 (significant, separately identifiable evaluation and management [E/M] service by the same physician on the same day of the […]
When one has to manage something as important as the claims submission for your optometry practice, many can be defensive of the process as it directly connects with their revenue cycle. As a healthcare service provider and a facility owner, it’s great to keep an eye on the processes that are making your practice earn […]
For a surgeon or medical practitioner, group practice, or clinic, insights into how specialty medical billing works can be a scary task. A billing agent that does not bill the sittings correctly misses deadlines, or does inadequate follow-up can have an abysmal effect on your facilities’ bottom line. However, a well-organized billing service cannot only […]
Medical billing and coding for general surgery are not as simple as you think. Besides being educated in procedures ranging from hernia repair to bladder surgery, the billing and coding staff need to be knowledgeable in the proper use of the global surgical package, modifiers for surgeon roles and same-day procedures, and citations for unlisted […]
Matching CPT code with an ICD 10 code, would seem to be a very straightforward process but there are always variations/exceptions to everything. Sometimes, there are related services that the physician is performing, global periods to contend with, etc. Modifiers will clarify extenuating circumstances, which should allow for payment when they otherwise may not. That […]
Matching CPT code with an ICD 10 code, would seem to be a very straightforward process but there are always variations/exceptions to everything. Sometimes, there are related services that the physician is performing, global periods to contend with, etc. Modifiers will clarify extenuating circumstances, which should allow for payment when they otherwise may not. That […]
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