Healthcare providers focus on providing high-quality, equitable, and safe care as patient care and patient satisfaction are the ultimate motives for running practice. Patient billing is an important part of the care experience, where most practices face challenges day-to-day basis. Most of the surveys focusing on patient satisfaction report that patient bills can be difficult […]
During the COVID-19 pandemic, mandatory social distancing and the lack of effective treatments have made telemedicine the safest interactive system between patients and providers. Government authorities dramatically expanded telemedicine access during the pandemic. But as COVID is ebbing away and public health emergencies (PHE) in many states are ending, how does it will impact telehealth […]
As an attempt to lower drug costs, the Centers for Medicare & Medicaid Services (CMS) released an interim final rule that implements a new payment model, known as the Most Favored Nation (MFN) Model. Its approach is to pay no more for high-cost Medicare Part B drugs and biologicals than the lowest price that drug […]
It’s quite common for healthcare providers to outsource their billing activities to a medical billing company. Billing and coding for various medical specialties are challenging tasks due to billing guidelines, payer reimbursement policies, updated ICD-10 codes, and accurate use of procedure codes & modifiers. An orthopedic surgeon recently remarked that he was thinking about outsourcing […]
CMS recently proposed a rule to improve prior authorization processes by reducing the burden on providers and patients. This proposed rule would place new requirements on Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs, and Qualified Health Plans (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of […]
To bill, any healthcare service to an insurance carrier, the provider, or the health organization should be credentialed by that insurance carrier. Provider credentialing is one of the most important processes of practice management. In provider credentialing, you are enrolled in the insurance carrier’s network and get authorized to render services to the patients who […]
Orthopedic surgeons are increasingly incorporating physical and occupational therapy services into their practices. In-house billers, who may be inexperienced with the new services, terminology, and associated CPT codes, may be unsure about billing for therapy care. Medical Billers and Coders (MBC) is a leading medical billing company providing complete revenue cycle services. We keep on […]
In the healthcare sector, maintaining standards is essential to ensure high-quality medical care is provided to patients. There is no room for treatment errors and costs remain optimum; that’s why credentialing is crucial. Credentialing is a quality assertion process among medical practitioners to bring down the incidence of medical errors. Provider credentialing involves a thorough […]
January 1, 2017, onwards Medicare provided coverage for cognitive assessment and care plan services. Reimbursement requires cognition-focused evaluation, identification of caregivers and caregiver needs, and development, revision, or review of an Advance Care Plan. Effective January 1, 2022, Medicare increased payment for these services to $282 (it will get geographically adjusted) when provided in an […]
Many practitioners have difficulty being paid for Transitional Care Management (TCM) services. In many cases, claims submitted for TCM services have not been paid due to several common errors in claim submission. In particular, the practitioner should ensure that the entire 30-day TCM service was furnished, the service began with a qualified discharge from a […]
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