Specialities
Billing for continuous glucose monitor (CGM) services uses two CPT codes: 95250 for the technical component and 95251 for analysis and interpretation, each requiring at least 72 hours of monitoring and billable once per month per patient. On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule which was […]
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 […]
Multiple E/M visits for the same patient on the same day can occur when a physician or other qualified healthcare professional provides separate medical services or evaluates the patient for different problems during the same date of service. However, reporting multiple E/M services depends on the circumstances of the visits, payer-specific rules, and the documentation […]
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 […]
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 […]
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 […]
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 […]
It turns out that third-party medical billing can be extremely beneficial for medical practices because medical billing can take up a lot of valuable time. Moreover, it is difficult to find and train people to handle billing and coding complexities. Plus, if claims are processed slowly or incorrectly, they can negatively impact your practice’s revenue. […]
Workers’ compensation billing is the process of billing an employer’s workers’ comp insurer, not the patient’s health plan, for treatment of a work-related injury or illness. Providers submit a CMS-1500 claim with the date of injury, the workers’ comp claim number, and supporting documentation, and follow fee schedules set by each state’s compensation board. Workers’ […]
Providers seeing a 2 percent payment decrease on their Remittance Advice (RA) is due to a mandatory sequestration payment reduction. Claim adjustment reason code (CARC) 253 is used to report the sequestration reduction. The code will appear as a CO 253 on the RA ‘Sequestration-reduction in federal payment’ as the reason. For the Medicare Fee-for-Service […]
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