According to bcbsnc.com, “Durable medical equipment (DME) is any equipment that provides therapeutic benefits to a member because of certain medical conditions and/or illnesses, and that can withstand repeated use, is primarily and customarily used to serve a medical purpose, and is appropriate for use in the home.” DME items include wheelchairs, cranes, orthotics, compression […]
Medicare Part B Coverage An ambulance service is deemed necessary for a patient who is either unconscious, heavily bleeding, or is unable to travel through any other mode of transport. Ambulance services are separately payable under Medicare Part B which pays 80 percent of the Medicare-approved cost. Ambulance providers cannot charge more than what is […]
Optometry includes curing vision-related problems, fitting lenses, diagnosing and treating certain ailments of the eye, sight testing, and correction by the initiation of diagnosis, treatment, and the supervision of vision changes. Having its own set of issues with billing and reimbursement, Optometry must focus on receiving the entire payment for the treatment provided. Rules for […]
The voluntary program Physician Quality Reporting System (PQRS) is meant to pay eligible professionals (EPs). This includes physicians under Medicare as well as a few select therapists and service providers who extend their services to beneficiaries under Medicare. However, there does exist a bit of confusion with medical practices on whether the requirements of PQRS […]
The changing regulatory pressures coupled with evolving payments and care delivery models are known to have implications on physician’s time especially when it comes to direct care for the patient. In order to implement better care delivery models many practices outsource either part or the entire RCM process. How can one make such decisions? Based […]
Accurate coding and billing processes are the core elements for a successful compliance program for healthcare providers and physicians which can translate into a successful Revenue cycle Management process leading to enhanced revenues. It involves appropriate and precise application of billing codes, diligent documentation of medical records, and correct charging for medical services rendered. But, […]
Constant changes take place in the healthcare industry with respect to codes, rules, and standards. As 2015 saw the introduction of ICD-10, the knowledge of these codes along with other challenges shall unquestionably be carried forward to 2016. So how does the medical billing industry stay abreast and prepare themselves for such challenges? Here’s what […]
When doctors take the Hippocratic Oath they vow to take care of the patient and uphold ethical standards. However, in the modern era, only following the traditional custom will cause the physician to run out of business. Revenue Follow-up is one of the most important tasks for a physician. Having said that, the fact is, […]
ICD-10 has been well into the system for four months now. Although a small percentage has reported issues with the transition, a majority have experienced a smooth transition. While this is certainly good news for the healthcare industry, it probably is a little too soon to call it a success. In reality, ICD-10 crisis could […]
The medical practice has, and, is seeing a great many changes taking place in terms of healthcare reforms, the CMS rules & regulations with respect to reimbursements, and the ICD-10 coding system recently introduced in October 2015. These changes have affected a broad spectrum of both small, mid, and large healthcare providers specifically in terms […]
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