Practice Management Guidelines to Improve Practice Collections

Receiving accurate insurance reimbursement for delivered services is always been a challenge for healthcare providers. Practice owners spend most of their time and energy on doing administrative tasks of medical billing to receive sufficient insurance reimbursements to cover overhead expenses and provide quality care. But often they make this task even harder by doing sloppy […]

2022 Revised Codes for Principal Care Management

In the Final Medicare Physician Fee Schedule (MPFS) for 2022 issued on November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) added five new CPT codes in the categories of Chronic Care Management (CCM) and Principal Care Management (PCM) and increased reimbursement for already existing codes in the same categories. These codes are […]

Basics of Medicare Remittance Advice (RA)

The A/B Medicare Administrative Contractors (A/B MACs), and Durable Medical Equipment Medicare Administrative Contractors (DME MACs) send to providers, physicians, and suppliers, as a companion to claim payments, a notice of payment, referred to as the Remittance Advice (RA). RAs explain the payment and any adjustment(s) made during claim adjudication. For each claim or line […]

Billing for Continuous Glucose Monitor (CGM)

On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule which was implemented on February 28, 2022. This final rule addressed the classification and payment of continuous glucose monitor (CGMs) under the Medicare Part B benefit for durable medical equipment (DME). This rule expanded the classification of DME to […]

Improving Documentation for Pain Management Services

Documentation of medical services is necessary to provide information to assist health care professionals in providing services to patients which are medically necessary. Apart from helping in medical billing and coding, it also reflects the competency and character of the physician. Even though the role played by documentation has always been a supportive one, it’s […]

Can You Bill Multiple E/M Visits in Same Day for Same Patient?

Multiple E&M visits on the same day for the same patient address instances when a physician(s) or other qualified health care professional(s) reports a single code for multiple medical and/or Evaluation and Management (E/M) services for a patient on a single date of service. General E/M Code Procedure: Generally, a single E/M code should be […]

Keeping Track of Financial Health of Your Practice

Keeping track of the financial health of your practice is important for many reasons. On the most basic of levels, it allows you to keep the doors open. You can retain your staff, keep their morale high and remove the headaches associated with worrying about money month to month. Most importantly, though, it allows you […]

Increase your Practice Collection by Educating Patients

Current fact suggests, nearly 6 in 10 patients either rarely or never received an estimate of out-of-pocket costs before they received treatment. As per a survey report from TransUnion Healthcare, 75 percent of patients mentioned that they can play better if they receive pre-treatment estimates of out-of-pocket costs well in advance. The healthcare experts agree […]

Reducing Medical Billing Staff Burnout

According to MGMA’s (Medical Group Management Association) report, amongst the COVID-19 pandemic, burnout among medical billing staff becomes an overwhelming problem. MGMA reported a combined 30% turnover rate specifically among front office and operational staff, the highest of any other healthcare career category. Continuously changing payer policies and reimbursement guidelines put additional pressure on medical […]

Proposed Changes to Shared Visit Billing

Basics of Shared Visit Nurse practitioners (NPs) or physician assistants/physician associates (PAs) and physicians sometimes ‘share; patient visits. A shared visit which is also called a split visit is one where both types of clinicians participate in evaluating and managing a patient on a given day. The Centers for Medicare & Medicaid Services (CMS) defined […]

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