• 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.
    • Doctors: Get Ready to Accept Chip Credit Cards in Your Practice
      The looming switch to ICD-10 this fall isn't the only financial transition affecting medical practices in the future. U.S. banks are stepping up security to reduce fraud by switching from strip-based to microchip-based cards by the end of the year.
    • “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.
    • Payer Roundup, July 2015
      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

    • Collections: Humana Code Edit and Policy Change Notifications
      Staying up-to-date on code-editing updates could prevent claim denials.
    • The Move to ICD-10: Dates of Service
      Because ICD-10 is service-date driven, you’ll use ICD-9 codes when filing a claim for a service provided before Oct. 1, 2015, even if you file the claim after Oct. 1.
    • Revised LCDs Give Updated Medicare Coverage Information
      Revised local coverage determinations (LCDs) from Novitas Solutions recently took effect or will take effect Aug. 13, 2015. See if any apply to your practice, and read their guidance for submitting correct Medicare claims to Novitas for payment.
    • OIG Focuses Fraud Efforts on Physician Compensation
      A recent U.S. Office of Inspector General (OIG) fraud alert warns that physician compensation arrangements may result in significant liability.
    • Call for Two-Year ICD-10 Grace Period Gains National Support
      Physician leaders from three states have joined TMA in asking the federal government to help doctors dodge disaster by adopting a two-year, penalty-free grace period to shift to the new ICD-10 medical billing and coding system. The four largest state medical associations -- from Texas, California, Florida, and New York -- sent a letter to Andy Slavitt, acting administrator for the Centers for Medicare & Medicaid Services (CMS), which will roll out the mandatory shift to ICD-10 on Oct. 1.
    • Medicare Chronic Care Management: Who Can Bill for Service?
      As of Jan. 1, 2015, Medicare pays separately for chronic care management (CCM). Be sure you are clear about whose services you can bill for and understand “incident to” billing.
    • Medicare Pays for Chronic Care Management That Uses an EHR
      Medicare now pays for chronic care management (CCM) services, if your practice has a certified electronic health record (EHR). The CCM service as laid out by Medicare is extensive, and some components require the use of a certified EHR or other electronic technology.
    • TDI Sets Standard Drug Preauthorization Form
      Building on a TMA-supported win from last legislative session, the Texas Department of Insurance (TDI) adopted a rule last month that creates a standard prior authorization form for prescription drug benefits. Prescribing physicians and other practitioners can use the form to request prior authorization from health benefit plan issuers. The new form is available on TDI's website.