A modifier is a two-digit numeric or alphanumeric character reported with an HCPCS Modifier code, when appropriate. Modifiers are designed to give Medicare and commercial payers additional information needed to process a claim. This includes HCPCS Level I (Physicians’ Current Procedural Terminology [CPT®]) and HCPCS Level II codes. A modifier provides the means by which […]
There are several major issues facing compliance officers today, such as HIPAA, Stark Law, and Anti-kickback Statute issues, as well as many billing compliance issues. Billing issues continue to appear in federal government False Claims Act settlement agreements and government audit reports. Here, we’ll discuss incident-to and shared billing compliance pitfalls and focus on what […]
Prior authorization is a check run by some insurance companies or third-party payers before they will agree to cover certain prescribed medications or medical procedures. There are a number of reasons that insurance providers require prior authorization, including age, medical necessity, the availability of a generic alternative, or checking for drug interactions. A failed authorization […]
High-Deductible Health Plans (HDHP) have become increasingly popular since the Medicare Modernization Act of 2003 authorized portable, tax-advantaged health savings accounts (HSAs) designed to be coupled with these plans. Supports of HDHP advocate that, these plans as an effective mechanism for controlling health care costs by creating cost-conscious health care consumers who will look for […]
Medical Practice complains about the volume of incoming telephone calls and how much time their employees spend handling them. Why is your Medical Practice getting so many calls? It is the only way patients can make or change appointments. Patients call the office for refill authorization. Patients were distracted during their visits and are calling […]
Not only is wound coding and documentation is a daunting task, but also attracts intense inspection from auditors, with severe financial penalties for mistakes. And it’s only gotten more challenging with the new ICD-10 changes. What is included in the wound care billing guidelines 2019? An infected surgical wound, T81.4xxA, is among those 51 codes […]
A healthy heart is essential to lead a healthy and happy lifestyle. There are a lot of things that can go wrong with your heart, and sometimes the symptoms that something is wrong are not always obvious. A cardiologist is a health practitioner who specializes in diagnosing problems with the heart and surrounding arteries. What […]
As the present USA healthcare trends focusing more on Reimbursement Methods like value-based care, the fee-for-service is under intense scrutiny. Often labeled as an antiquated payment model, it promoted over-utilization by physicians and patients, while creating fragmentation among healthcare service providers. The Affordable Care Act of 2010, along with MACRA legislation in the year 2015, […]
With 2019 approaching, there has been a buzz about new medical billing codes. The year 2018 has been hectic for medical and healthcare industry professionals as ICD-10-CM codes introduced nearly 500 changes, 33 of them in Obstetrics and Gynecology, as well as in several other specialties. So, what’s new to expect in 2019 OB-GYN ICD […]
HCC is also known as hierarchical condition category bank on ICD-10 coding. The coding is assigned to risk scores to patients. Each HCC is mapped to a precise ICD-10 code. Let MBC handle your HCC Coding so that you can focus on your core practice. In today’s hyperactive world, it’s easier than ever to connect […]
Connect with us by filling out this form. Let’s tailor a
solution that fits your needs perfectly.
