New Updates in HIPAA Regulations for 2021

The Healthcare Insurance Portability and Accountability Act (HIPAA) plays a critical role in healthcare organizations and the main objective of (HIPAA) is to improve the efficiency and effectiveness of the health care system. HIPAA regulations were mainstream in 2020 due to COVID-19 testing, status, transmission, and care. HIPAA the act was signed into law in 1996 […]


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Basics of Medicare Payment for Ambulatory Surgical Services (ASCs)

Medicare covers surgical procedures provided in freestanding or hospital-operated ambulatory surgical centers (ASCs). In January 2008, Medicare began paying for facility services provided in ASCs— such as nursing, recovery care, anesthetics, drugs, and other supplies—using a new payment system that is primarily linked to the hospital outpatient prospective payment system (OPPS). (Medicare pays for the […]


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Ambulatory Surgical Center Terminated Procedures

The following guidance determines the appropriate ambulatory surgical center (ASC) facility payment for a scheduled surgical procedure that is terminated due to medical complications, which increase the surgical risk to the patient. Payment is denied when an ASC submits a claim for a procedure that is terminated before the patient is taken into the treatment […]


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Received Payer Request for Medical Records? Keep Calm and Take These Steps

If a letter were to arrive at your organization in an innocuous-appearing envelope, you may be afraid to open it. It’s unsettling for a payer to request medical records for claims that have already been paid. It is becoming more and more common for providers to receive what appear to be innocuous medical records requests […]


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Understand Payment Rates and Basics of ASC Billing

An Ambulatory Surgical Center (ASC) is defined by CMS as a facility with the sole purpose of providing outpatient surgical services to patients. ASC is a facility that, very simply, specializes in outpatient procedures. Procedures done at an ASC are more extensive than those done at the typical provider’s office but are not so involved […]


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General Coding Guidelines for Osteoporosis

Osteoporosis is a bone disease that involves abnormal loss of bony tissue resulting in fragile or porous bones. Without appropriate treatment, osteoporosis can worsen. As bones get weaker and thinner, the potential risk for fractures increases. Documentation is very important and physicians must ensure timely medical documentation to ensure appropriate treatment for these patients. Medical […]


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Increasing Your Practice Revenue by Adding New Patients Using SEO

As we all know, in the current age of the internet, having a website for your practice is a must. But if your website is not properly optimized then you would fall behind the competition.  SEO stands for ‘search engine optimization. It is the process of getting organic traffic from search engines. In other words, […]


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Top 5 Questions Regarding Outpatient Reimbursement for Wound Care

Do outpatient reimbursement for Wound Care challenges frustrate you a lot? Medicare reimbursement regulations that are currently impacting wound care practices. Wound care professionals still have to follow the coding, payment, and coverage regulations for submitting claims to traditional Medicare. Issues in Outpatient Reimbursement for Wound Care: Q. 1: Why it is crucial to know […]


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Cardiology Billing Guidelines Made Easier With Coding Alert

This year with the new cardiology Billing and guidelines, cardiologists are in a tight spot. Furthermore; CMS lowers the reimbursement as part of its multiple procedure payment reductions for imaging services. This will lead to a reduction of 22% on the technical modules of the lower-priced services. It is imperative to have the right coding […]


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Murphy signed Out-of-Network Healthcare Billing Law in New Jersey

Governor Phil Murphy on August 30th, 2018 signed a bill that ended the decade-long battle to address the issue of the cost and impact of expensive medical bills for residents in the state. In a statement, Gov. Murphy said, “Today, we are closing the loophole and reigning in excessive out-of-network costs to prevent residents from […]


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