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Physician Credentialing Services in 2020

Physician Credentialing Services in 2020

A couple of years ago medical professionals treated credentialing as an optional or unnecessary step to increase their clientele. Nowadays the scenario has completely changed, physicians are emphasizing not only on services but also on credentialing. The process of verifying and organizing professional records of the doctor is termed as physician credentialing in the healthcare […]

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Physical Therapy Billing Guidelines

Physical Therapy Billing Guidelines

Every industry has rules and regulations to prevent abuse, fraud, and waste, and Medicare is no option. Guidelines for Medicare and Medicaid providers for physical therapy billing include a segment on how much time you have to spend with a patient to be “bill worthy.” Most of the people read or hear about rules like […]

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Avoid Common Errors in Ambulance Transportation Billing

Avoid Common Errors in Ambulance Transportation Billing

An ambulance is a part of Emergency Medical Services (EMS), which is a billable event and most of the insurance companies such as Medicaid and Medicare compensate for it. Billing and coding for ambulance services may be complex owing to different modes of transportation like air, water, and ground. Apart from this, reimbursement of ambulance […]

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Ambulatory Surgical Centers-Progressive Model for Surgical Services

Ambulatory Surgical Centers-Progressive Model for Surgical Services

Ambulatory Surgical Centers (ASC) one of the fastest-growing medical services today that offers patients the opportunity to have selected surgical and procedural services performed outside the hospital setting. Physicians have contributed to the development of ASCs and they have the opportunity to directly control their surgical practices if they operate in ASCs as compared to […]

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Broadening Telehealth Coverage for Medicaid and CHIP

Broadening Telehealth Coverage for Medicaid and CHIP

Trump Administration on 23rd April 2020, released a new toolkit for states to help accelerate the adoption of broader telehealth coverage policies in the Medicaid and Children’s Health Insurance Programs (CHIP) during the 2019 Novel Coronavirus (COVID-19) pandemic. This release builds on the agency’s swift actions to provide states with a wide range of tools […]

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Medicare Increases Payment for High-Production Coronavirus Lab Tests

Medicare Increases Payment for High-Production Coronavirus Lab Tests

This announcement made by CMS-Rulings on 14th April 2020. CMS-Rulings provide clarification and interpretation of complex or ambiguous statutory or regulatory provisions relating to Medicare, Medicaid, Utilization and Quality Control Peer Review, private health insurance, and related matters. This Ruling articulates CMS policy concerning the designation and payment of certain clinical diagnostic laboratory tests related […]

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Maximizing Support to Medicaid and CHIP during COVID-19

Maximizing Support to Medicaid and CHIP during COVID-19

Trump Administration on 22nd April 2020, released new tools to strip away regulatory red tape and unleash new resources to support state Medicaid and Children’s Health Insurance Programs (CHIP) during the 2019 Novel Coronavirus (COVID-19) outbreak. Because of the President’s bold action in declaring COVID-19 a national emergency, CMS now has a full suite of […]

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CMS Guidance for Laboratories during COVID-19 Emergency

CMS Guidance for Laboratories during COVID-19 Emergency

CMS is committed to taking critical steps to ensure America’s clinical laboratories are prepared to respond to the threat of 2019 Novel Coronavirus (COVID-19) and other respiratory illnesses to ensure reliable testing as well as ensuring patient health and safety. CMS is issuing this guidance to laboratory surveyors to provide important guidance to surveyors and […]

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Adult Elective Surgery and Procedures Recommendations during COVID-19

Adult Elective Surgery and Procedures Recommendations during COVID-19

To aggressively address COVID-19, CMS recognizes that the conservation of critical resources such as ventilators and Personal Protective Equipment (PPE) is essential, as well as limiting exposure of patients and staff to the SARS-CoV-2 virus. The following recommendations are guidance to limit non-essential adult elective surgery and medical and surgical procedures, including all dental procedures. […]

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Prior authorization (PA) Policy Changes related to COVID-19

Prior authorization (PA) Policy Changes related to COVID-19

The information Prior authorization and guidance provided in this document are believed to be current and accurate at the time of posting this article. Major Medical Insurance Plans Plan Effective Date(s) Policies Aetna Check the Aetna COVID-19 Communications Update for state-specific information and detailed requirements 3/25/20 – 5/6/20 Transfers: Initial PAs waived in the following […]

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