Tag Archives: ICD 10 Training

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

Posted on May 20, 2019 by MedicalBillersandCoders.com

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 … Continue reading →

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Understand Payment Rates and Basics of ASC Billing

Posted on May 16, 2019 by MedicalBillersandCoders.com

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 … Continue reading →

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What is MIPS and How it Affects My Practice?

Posted on May 15, 2019 by MedicalBillersandCoders.com

What is MIPS? On November 1, 2018, CMS released revisions to payment policies under the Medicare Part B physician fee schedule for the Quality Payment Program (QPP) for the calendar year 2019. In accordance with one of the most bipartisan … Continue reading →

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Understand Basics of Optometry E/M Coding

Posted on May 14, 2019 by MedicalBillersandCoders.com

Typically, eye care practitioners don’t use the E/M codes for what most optometrists consider a general eye examination. They are more typically used for patient encounters where the patient presents with a medical complaint or a continuation of medical case … Continue reading →

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Common Denials for SNF and How to Avoid Them?

Posted on May 13, 2019 by MedicalBillersandCoders.com

Denial 1: Certification or Recertification Statement (Missing/ Lacked Information) From 2012-2014 the percentage rate of improper payments to SNF almost doubled all stemming from failure to obtain certification or recertification. General Guidelines: The Certification Statement must include that the individual requires skilled … Continue reading →

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Easy Tips for Quick, Accurate and Simplifying the Provider Credentialing Process

Posted on April 30, 2019 by MedicalBillersandCoders.com

Medical Credentialing is a process whereby insurance networks check to make sure that the provider meets the standards set out by the insurance company. In this process, they review a range of documents including medical licenses, malpractice insurance, schooling information, … Continue reading →

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Time-Based Billing for CPT Evaluation and Management

Posted on April 29, 2019 by MedicalBillersandCoders.com

Within the guidelines of the CPT code book, CPT has stated; “When counseling and/or coordination of care dominates (more than 50%) the physician/patient and/or family encounter (face-to-face time in the office or other outpatient setting or floor/unit time in the … Continue reading →

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