The modifier 58 is defined by CPT as “staged or related procedure or service by the same physician during the post-operative period.” It may be necessary to indicate that the performance of a procedure or service during the postoperative period was a) planned or anticipated (staged); b) more extensive than the original procedure, or c) […]
As we all know, in the current age of the internet, having a website for your practice is a must. But if your website is not properly optimized then you would fall behind the competition. SEO stands for ‘search engine optimization. It is the process of getting organic traffic from search engines. In other words, […]
A rejected claim contains one or more errors found before the claim was processed. Errors will prevent the insurance company from paying and the rejected claim is returned to the biller to be corrected. A rejected claim may be the result of a clerical error or a mismatched procedure and an ICD code. A rejected […]
What is Pre Authorization? Most of the carriers request to obtain prior authorization from them before the service/surgery. Prior authorization for health care services is required for certain services. If authorization is not obtained prior to performing the service, the insurer may not reimburse for the procedure. Most services requiring prior authorizations are surgical procedures […]
HCC coding also known as Hierarchical Condition Category coding is the important key element that decides the reimbursement benefits for a Medicare Advantage Plan that uses ICD diagnostic codes as the primary indicators of the member’s health status. Correct coding for the Medicare advantage plan will ensure clean claims for the physician practices. MBC is […]
The clearinghouse you work with has a huge impact on your business. The more efficiently your clearinghouse processes and returns your information, the faster you will get paid, and the more payments you will collect. Billing is at the core of your revenue cycle. Therefore, choosing the right clearinghouse for medical practice is an important […]
Most physicians strive to work ethically, provide high-quality medical care to their patients, and submit proper claims for payment. Trust is at the core of the physician-patient relationship. The Federal Government also places enormous trust in physicians. Medicare and other Federal health care programs rely on physicians’ medical judgment to treat patients with appropriate, medically […]
The CMS has developed the Healthcare Common Procedure Coding System (HCPCS) for reporting medical procedures and services. Some of the most commonly used HCPCS Level II Codes, J-codes are used for non-orally administered medication, chemotherapy, and immunosuppressive drugs, and inhalation solutions as well as some orally administered drugs. Submitting Claims with J-codes: HIPAA required that […]
When outstanding patient balances grow out of control, your practice may feel there’s no option but to place them in the hands of a collection agency. Putting debt professionals in charge is the best way to get your payment… right? Not always. Physicians and practice managers often resort too quickly to the services of a […]
The revenue cycle process and its management have continuously progressed over the last few years to keep up with the changes occurring in the healthcare industry. 2020 is no exception. When we talk about healthcare units and hospitals, the primary thought that comes to one’s mind is the patient care experience as it relates to […]
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