• Billing and Coding

  • Are you taking advantage of these resources?

    • Have coding or billing questions?

      Contact TMA’s certified coders at (800) 880-1300, ext. 1414 or at paymentadvocacy@texmed.org for assistance.
    • Deadlines for Doctors

      Find out about upcoming state and federal compliance timelines and key health policy issues that impact Texas physicians. Learn about topics including the new ICD-10-CM implementation date on October 1, 2015.
    • Practice Consulting

      Need a coding and documentation review? Contact TMA’s Practice Consulting. 
    • 30-Minute Billing Cure

      TMA staff experts provide free half-hour consultations to member physicians and their employees at the county society headquarters. Contact your CMS to see when mini-consults will be in your area.
  • The Ins and Outs of Billing and Collections

    • TMA Webinars Cover Revenue Cycle, Claims Submission
      This series will cover prompt payment rules and clean claims submissions that help ensure physicians are paid fairly and in full. It will also address the discomfort many feel about asking patients for money and will outline how to reduce lost revenue, how to create a collection policy for your practice, how to implement effective and tactful collection strategies, and how to talk to patients from whom you need to collect payment.
    • Business Management Help From TMA
      The TMA Financial Trend Tracker is a free online tool to help association members and their staff track monthly and yearly net collection ratios, accounts receivable percentages, and new and established patient visits. The tool presents a practice's key performance indicators via easy-to-read graphs and charts.
    • Sending Patient Accounts to Collections
      We have several patient accounts (due to no insurance, insurance termed, patient co-insurance) that are extremely high-dollar accounts. On most of them, the patients pay minimal monthly payments, e.g., $10 or $20. Some are even on “monthly budgets” set up long ago to pay these amounts. Can we legally turn these accounts over to collections to reduce our accounts receivable? 
    • “Incident to” and the Initial Medicare Visit
      Novitas Solutions will deny or downcode claims for initial office visits billed as "incident to" when a nonphysician practitioner performs the initial history and physical.
    • Automate Drug Prior Authorizations Free With CoverMyMeds
      If you are not using CoverMyMeds for drug prior authorizations (PAs), you should take a look at this free service that streamlines a typically tedious task.
    • Private Payer Round-Up, October 2014
      In case you missed these — here is a roundup of coding, payment, and policy changes and tips from commercial payers, compiled by TMA’s reimbursement specialists. If you have questions about billing and coding or payer policies, contact the specialists at paymentadvocacy@texmed.org for help, or call TMA Knowledge Center at (800) 880-7955. 
  • Coding

    • Six Medicare Tips: New and Notable
      Claims, coverage, coding, and more: Here are some Medicare changes and reminders that might affect your practice.
    • Note These Two Medicare 2015 Coding and Billing Updates
      Two upcoming Medicare changes affect Medically Unlikely Edits and reporting on certain claims where the physician or supplier is under another Medicare payer jurisdiction.
    • New CMS Modifiers Further Define Modifier 59
      The Centers for Medicare & Medicaid Services has established four new modifiers to define subsets of the commonly — but often mistakenly — used modifier 59.
    • Business Boot Camp Webcast
      Practice costs — like any other business’ operating costs — continue to rise. Two-thirds of Texas physicians report having trouble covering payroll and other practice expenses because of untimely or inadequate payment from insurers and government payers.
    • TDI FAQs Address 90-Day Grace Period, Prompt Pay
      The Texas Department of Insurance (TDI) has updated its FAQs for Health Carriers to include information about the federal 90-day grace period granted to patients with subsidized ACA health insurance marketplace coverage and about prompt payment of claims.
    • CMS Sets ICD-10 Testing Dates
      The Centers for Medicare & Medicaid Services (CMS) has instructed Medicare administrative contractors to promote three specific testing weeks with health professionals and to provide data and statistics to CMS that demonstrate readiness for the ICD-10 transition.
    • Code Correctly for Flu Season 2014-15
      Here is where you can find coding and billing information for various payers to make sure you get paid correctly during the 2014-15 flu season.
    • Use Modifier 50 to Code Medicare Bilateral Surgery Claims
      Are you billing Medicare correctly for bilateral surgical procedures? Remember this rule to avoid denied claims.