Medicare Covered ASC procedures are those surgical services that are recognized by CMS on a posting that is upgraded on a yearly basis. Physician billing companies and surgical billing with some surgical procedures covered by Medicare are not on the ASC list of secured surgical methodology. For surgical procedures that are not Medicare Covered ASC […]
One may well question the need to be aware of the difference between Emergency and Non-Emergency Ambulance Transportation. But the need to know this is necessary when it affects billing, especially since Medicare has tightened rules about the usage of ambulance services, to combat financial fraud, and more so for three states Pennsylvania, New […]
Rules for Medicare & Medicaid Optometry may differ with states and it is beneficial to know the differences. Although Medicare and Medicaid optometry sounds almost the same, they are quite different from each other. Medicare is meant for seniors who have crossed the age of 65, though younger people with certain disabilities are eligible as […]
The constant change in the healthcare industry has impacted timely reimbursement for medical practices over the past few years. Pathology Medicare and Medicaid have gone on a reduction spree as far as physician reimbursements are concerned. Most third-party payers like Cigna and Aetna are keener on signing up contracts with physicians that focus on fee-for-service, […]
The ambulance billing services industry is growing. Medical Billers and Coders (MBC) has the expertise required to streamline revenue for Ambulance transportation clients, providing end-to-end revenue cycle management services. With vast medical coding requirements and deep knowledge required for medical billing, the EMS billing services industry is fast expanding to cater to the growing needs […]
A critical function of any healthcare provider, including pharmacy, is the Accounts Receivable segment. Failure at this node can lead to the loss of much revenue. To achieve optimal organizational performance every business has to create a balance of people, processes and technology to support them leading to a workable environment. It is a known […]
Long-standing concerns in DME (Durable Medical Equipment) known for unquestionable billing practices, led the government to take action for tackling fraud in the insurance industry. Medicare, the nation’s largest health insurance program, regulates the billing structure of the maximum number of healthcare providers. Due to its highly fragmented nature, Medicare is prone to widespread fraud […]
Getting credentialed with the right insurance panels is key to growing your practice revenue. However, Credentialing for Optometry Practices can be a daunting task. Are you aware that a Medicare application is a minimum of 30 pages for a solo provider and may surpass 50+ pages if you are a corporation or group practice? Even […]
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 […]
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