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Reimbursement

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Billing and Collections

Articles | Consulting Services | FAQs | Links | Products & Services | Tools 

Articles

• Practice E-Tips on Billing and Collections
  
• At-a-Glance Billing Guidelines
  
• Are You Ready for the RAC?
  
• Medicare Begins 2008 PQRI Payments
  
• It's 'Collection Season'
  
• TMA Monitors State Recoupment Actions
  
• Get Payment Help from TMA
  
• TMA Weighs in on Weighty Issues
  
• Social Networking on TMA Web Site
  
• New Law Requires Billing Disclosures by Physicians
  
• TMA, AMA: Red Flags Raise Red Flags
  
• Patients' Right to Know
  
• United Scraps 'Usual and Customary' System
  
• We Need Your 'Lowball' Stories
  
• Tell Us How Plans 'Lowball' You
  
• TMA Offers Tools to Navigate the Coding Maze
  
• TMA to CMS: Reform the GPCIs
  
• Don't Let Insurance Companies Lowball You
  
• Assessing Your Billing and Collections
  
• NUCC Changes Claim Form
  
• CMS Revises ABN Form
  
• TMA Payment Advocacy Services
  
• SB 418 CMS-1500 and HB 610 HCFA-1500 Forms and Guidelines
  
• New CMS-1500 Claim Form and Updated Instruction Manual
  
• Practice Change in the TMA Reimbursement Community
  
• In Due Time: Maximizing Collections in Your Practice
  
• Don’t Lose Revenue With an Outdated Fee Schedule
  
• Medical Board Sides with Physician over Pathology Billing Issue
  
• Incident to Billing Criteria (Medicare Option #2)
  
• Prospective Relief - Fair Payment Rules
  
• Systematic TWCC Billing/Payment Process Problems: Barriers to Getting Paid
  
• Billing Guidelines for Nurse Practitioners (NP), Clinical Nurse Specialists(CNS), and Physician Assistants (PA)
  
• Action: Physician Services offers collection tips
  
• SB 418: Prompt Pay Final Rules
  

Consulting for Your Practice

• Billing and Collections Assessment: A consultant will review your practice's business office operations, focusing on your complete billing and collections process.
• Billing and Collections Training: Your consultant will provide on-site training to assist you and your staff in developing policies and procedures for effective billing and collections processes.
• TMA Mini-Consultation Program: Having problems with coding, billing, reimbursement, denial of services, or filing of claims? TMA staff travel to county medical societies across the state and conduct free 30-minute sessions with individual practices on these topics. Each physician or office staff member who attends receives a free CD-ROM full of helpful articles and reference materials, and a packet of TMA resources on managed care, practice management, and more. Contact your county medical society to schedule a mini-consultation. Questions about the Mini-Consultation program?  Contact Genevieve Davis  at TMA. Free to TMA members.

FAQs

• Answers to the questions about billing and collections most commonly asked of TMA.

Links

• American Medical News
• Centers for Medicare & Medicaid Services
• Texas Department of Insurance
• Texas Medicaid Program
• TMA Communities (online networks for connecting with other physicians, practice managers, and staff)
• TMA Knowledge Center
• Trailblazer Health Enterprises provides services to Medicare beneficiaries and health care professionals

Products and Services

• TMA Endorsed Services
• TMA Practice Management Publications

Tools

• Payer Web sites: Contracted fees and payment policies - AMA
• TrailBlazer Develops NPI Training Tool (Action, Aug. 1, 2008)  New
• Office Policies and Procedures Manual - free Charity Care and Billing the Patient policies New
• New CMS-1500 Sample Claim Form and Updated Instruction Manual
• How to Complete the Medicare CMS-855B Enrollment Application — Presentation (PDF )
• How to Complete the Medicare CMS-855I Enrollment Application — Presentation (PDF )
• How to Complete the Medicare CMS-855R Enrollment Application — Presentation (PDF )
• Application Guide for Medicare Enrollment With Form 855I (PDF)
• Free Introductory Online Program on the National Provider Identifier (NPI)  (January 2007)
• TMA's Medicaid Global Billing Periods Tool: Under Medicaid's global fee structure, routine care related to surgery or a diagnostic procedure, such as a follow-up office visit, is considered part of the procedure and should not be billed separately to Medicaid during a global period.  By knowing the global period for a procedure, you can determine the dates on which you can or cannot bill for another service.

• Endorsed Services
  
• Hassle Factor Log Resources
  
• Hassle Factor Log
  
• Hassle Factor Log Program User Information
  
• TMA Billing and Collections Yellow Pages
  
• Flex Your RVUs
  
• Sample Letters to Carriers
  

Coding

Articles

• Practice e-Tips on Coding
  
• Medicaid, Medicare to Reimburse for H1N1
  
• Are You Ready for the RAC?
  
• Medicaid Corrects Cardiac Code Errors
  
• Heard from HRI?
  
• Coding Resources Free Online for Members
  
• BCBS Coding Provisions in Effect
  
• Eureka! Feds Delay ICD-10 for Two Years
  
• TMA Offers Tools to Navigate the Coding Maze
  
• TMA to CMS: Reform the GPCIs
  
• NUCC Changes Claim Form
  
• Are You Losing Revenue by Undercoding?
  
• National Drug Code Requirement on Medicaid Claims
  
• TMA Payment Advocacy Services
  
• TMA Practice Consulting Can Help You Improve Coding Accuracy
  
• Sharpen Your Coding Skills for Better Reimbursement
  
• Prospective Relief - Fair Payment Rules
  
• Action: TMA Physician Services Offers Coding Know-How
  

Consulting for Your Practice

• Coding and Documentation Review: A review of claims, coding and medical record documentation is performed by a Certified Professional Coder to determine whether the practice is following payers’ guidelines for appropriate billing.
• Coding and Documentation Training: Our Certified Professional Coder will provide on site coding and documentation training to assist you and your staff in understanding documentation guidelines, inappropriate or inaccurate coding, and weaknesses in medical record documentation.
• TMA Mini-Consultation Program: Having problems with coding, billing, reimbursement, denial of services, or filing of claims? TMA staff travel to county medical societies across the state and conduct free 30-minute sessions with individual practices on these topics. Each physician or office staff member who attends receives a free handbook full of helpful articles and reference materials, and a packet of TMA resources on managed care, practice management, and more. Contact your county medical society to schedule a mini-consultation. Free to TMA members.

FAQs

• Answers to the coding questions most commonly asked of TMA.

Links

• AMA CPT®: Current Procedural Terminology
• Centers for Medicaid & Medicare Services
• TMA Communities (online networks for connecting with other physicians, practice managers, and staff)
• TMA Knowledge Center
• Trailblazer Health Enterprises­ ­provides services to Medicare beneficiaries and health care professionals

Products & Services

• TMA Endorsed Services
• TMA Practice Management Publications

Tools

• TrailBlazer Develops NPI Training Tool (Action, Aug. 1, 2008)  New
• How does your practice’s evaluation and management (E&M) utilization compare with that of other practices in your specialty? To find out where you stand, use TMA’s easy E&M coding tool .
• E&M Coding 
• Medicare Fee Schedules
• Sample Letter (SB 418): Appeal Letter for Services Incorrectly Denied
• Sample Letter: Getting to Know a Carrier's Surgical Billing Principles
• TMA Billing and Collections Yellow Pages

Last Published: 10/27/2009