Billing and Collections

Prevent Improper Code Bundling With New Medicare Tool - 02/15/2023

Physicians can take advantage of a new Medicare tool to sort through the thousands upon thousands of service codes that can be bundled together for claims payment – and avoid improper billing.

No Surprises Act Includes Directory Update Requirement - 02/10/2023

In addition to resolving payment disputes over out-of-network medical care, the federal No Surprises Act aims to make sure health plans’ practitioner directories stay up to date, and part of that aim puts an onus on physicians.

Medicine to Congress: Don’t Give Health Plans More Leverage - 02/09/2023

The federal government should take a balanced approach to surprise medical bills that includes commercially reasonable upfront payments and independent arbitration, the Texas Medical Association and many other medical societies are telling key members of Congress.

TMA Offers Remedies to Ease Surprise Billing - 02/08/2023

Texas patients sometimes feel the pain from unexpected out-of-pocket costs not covered by their health insurance, known as “surprise billing” or “balance billing.” The Texas Medical Association (TMA) is taking aim at the problem, which occurs when a health insurance company pays less than what a doctor charges, leaving the patient to pay the balance of the bill.

Here’s Your Billing and Collections Checklist for 2023 - 01/06/2023

TMA’s Reimbursement Services staff work year round with physicians and health plans to help make sure you get paid correctly and on time. They’ve put together a list of practical actions you can take at the start of 2023 to keep your billing and collections on track throughout the year.

OIG: Physicians Incorrectly Billing for End-of-Life Care Planning - 01/05/2023

Advance care planning (ACP) services were meant to give patients the opportunity to choose the care that is right for them at the end of their lives or during medical crises that could render them unable to make personal health decisions.

Check Claims Dates for Drug Administration as Coding Updates Loom - 12/02/2022

With annual updates to billing codes for medications set for Jan. 1, physicians are reminded to use the most current National Drug Code (NDC) and Healthcare Common Procedure Coding System (HCPCS) combinations when filing claims for drug administration.

E/M Revisions in 2023 CPT Code Set Aim to Simplify Documentation - 11/02/2022

In an effort to continue to tamp down physicians’ administrative burden, the American Medical Association has revised the codes and guidelines for most evaluation and management services in its 2023 Current Procedural Terminology code set.

No Penalties for Now in Medicare’s Appropriate Use Criteria Program - 10/25/2022

The Centers for Medicare & Medicaid Services (CMS) has said it would postpone indefinitely the payment penalty phase of its appropriate use criteria (AUC) program, which was expected to begin as soon as Jan. 1, 2023.

Practice E-Tips on Billing and Collections - 10/19/2022

Practice E-Tips on Billing and Collections

Practice e-Tips on Practice Operations - 10/11/2022

Billing Consulting HIPAA Forms Marketing Office Staff OSHA Patient Service Policies & Procedures Resources Billing Billing Medicare for Locum Tenens Billing Tip

Practice Operations Services - 09/16/2022

With the many challenges that face today's medical practices, business operations remain at the core of a practice's ability to be successful and profitable. Work with a TMA practice management consultant to identify and assess key or problematic areas of your practice.

Financial Management Services - 09/15/2022

Having sound financial policies and processes can help your practice attain a steady cash flow, maintain healthy collection ratios, increase staff efficiencies, and boost your overall bottom line.

Pass-Through Billing Generally Not Permitted - 09/14/2022

Pass-through billing occurs when an ordering physician requests a service and bills insurance for it but does not perform the service. Insurance companies generally forbid this practice.

Don’t Forfeit Your APM Incentive Payment; Act Now - 08/23/2022

Wondering where your 5% payment incentive is for participating in an advanced alternative payment model (APM) in the 2020 Quality Payment Program?

Operations Improvement Plan - 08/03/2022

TMA Practice Consulting is offering up to 20 AMA PRA Category 1 CreditsTM, per physician, when an Operations or Billing/Collections Assessment is performed for their practice.

Nickel and Dimed: Physicians Can Avoid Electronic Credit Cards and Their Fees - 07/29/2022

Some small medical insurance companies are trying to force physicians to receive payment via electronic credit cards, but medical practices can avoid this costly problem.

CMS Continues Webinar Series on No Surprises Act - 07/07/2022

Two upcoming webinars from the Centers for Medicare & Medicaid Services (CMS) – including one scheduled for next week – will educate physicians on the federal No Surprises Act (NSA) as part of a collaboration between CMS and the American Medical Association.

About Nurses as Assistants at Surgery - 06/22/2022

Learn what a first assistant nurse is, and how to bill when they assist during surgery.

Texas Medicare Contractor Answers Critical Care Coding Questions - 05/25/2022

Confused about how to quantify critical care services or delegate such services to nonphysician practitioners? You’re in luck.

Federal Surprise Billing Law in Effect: Get Educated - 04/05/2022

Despite ongoing litigation over certain aspects of the federal surprise billing law, the patient protection components of the No Surprises Act still took effect at the beginning of the year. With them come a number of changes that could significantly impact physician practices now that balance billing is largely prohibited.

Health Plans Not All Recognizing New Telehealth Code - 04/05/2022

A new telehealth code and a series of coding modifier descriptors have already taken effect in 2022 or will take effect soon. But not all health plans are recognizing the new coding elements, according to Texas Medical Association staff monitoring their status.

Guide to Insurance Overpayments and Refund Requests - 03/18/2022

Use this guide to help you and your staff properly assess refund requests from health plans.

Four Bill-Collecting Tips for New (or Any) Practices - 02/01/2022

Starting a practice can be daunting, and one challenge often overlooked is making sure you get paid. Although only a small number of patients will not pay you, or will pay slowly, they can hurt your bottom line. Writing off thousands of dollars in charges should not be an option.

Know State and Payer Rules for Clean Claims - 12/03/2021

Filing a clean claim gives you protections under Texas’ prompt pay law. For a claim to be “clean” you don’t have to fill out every field on the claim form, just the right ones.