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CMS to Recoup Chronic Care Management Payments - 12/06/2019

Some Texas physicians and outpatient facilities might have to refund payments they received for chronic care management services performed during 2015 and 2016 under the Medicare Physician Fee Schedule, federal officials said.


Practice e-Tips on Claims - 10/30/2019

Appeals Appealing Claims Can Have Appealing Results   Claim Forms Multiple Place-of-Service Codes on a Single 1500 Claim Form   Fees New Laws Require Billing Di


More Resources to Get Paid - 10/23/2019

TMA helps physicians “Get Paid.” In 2016, our Hassle Factor Log helped members recover more than $1.8 million in insurance payments.


United Healthcare Cuts Consults - 09/04/2019

United Healthcare is eliminating payment for consults in two phases – one that took effect June 1 for certain services, and their complete elimination starting in October. The change is an effort to align with the Centers for Medicare & Medicaid Services policy that eliminated payment for most consults in 2010, but it’s going to make it more difficult for many specialists to get compensated for the extra time and work those services require.


Guide to Insurance Overpayments and Refund Requests - 08/14/2019

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


How to File a Medicare Extended Repayment Plan - 03/04/2019

  Extended repayment plans (ERPs) are an option for returning overpaid money to Medicare. Ideally, you should request an ERP immediately after receiving the initial demand letter. However, you can request an extended payment plan any time while the overpayment is outstanding. 


Texas Clinics Repay Medicare for Improper Claims - 03/04/2019

Several Texas dialysis clinics in El Paso and the Dallas-Fort Worth area have had to repay Medicare for treating people in the country illegally.


Cornered: Proposed Medicare Fee Overhaul Could Box In Doctors - 02/05/2019

Proposed overhaul to Medicare payments for complex patient care visits and same-day office-based procedures could box in Texas physicians.


SB 418: Prompt Pay Final Rules - 01/24/2019

SB 418: Prompt Pay Final Rules


Sharing is Caring? Health Care Sharing Ministries Cause Confusion - 12/07/2018

Confusion surrounding health care sharing ministries puts Texas Medical Association on alert.


New Precerts, Edits From Aetna - 10/05/2018

Aetna will require precertification for endoscopic nasal balloon dilation, effective Nov. 1. This is one of several changes Aetna has announced to its National Precertification List.


New Laws Require Billing Disclosures by Physicians - 04/27/2018

A raft of new rules took effect Sept. 1 requiring, medical practices to reveal specific billing information to patients.


Private Payer Round-Up, March 2013 - 04/27/2018

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists.


Billing for H1N1 Vaccine Administration - 04/27/2018

For some payers, you may need to bill a penny for the H1N1 vaccine to be paid for administration.


TMA Payment Advocacy Services - 04/26/2018

TMA Payment Advocacy Services


What Stimulus Means to Texas Health Care - 04/24/2018

State health officials have released preliminary information on major health and human services allocations for Texas in the $789 billion economic stimulus bill President Obama signed. The largest portion is $5.45 billion for Medicaid through the first quarter of 2011.


Private Payer Update, June 2012 - 04/20/2018

  In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists (June 2012).


AMA: Bad Claims Payment Increasing - 04/19/2018

It's not your imagination. Most health insurers are getting worse at correctly paying physicians' claims, the American Medical Association says in its fourth annual National Health Insurer Report Card.


5010 Deadline Extended; Dual Eligible Problem Not Fixed - 04/17/2018

Acknowledging that many physicians and billing entities still aren't ready, federal officials are giving physicians three more months before it begins enforcing the use of Health Insurance Portability and Accountability (HIPAA) 5010 transaction standards. The new deadline is June 30.


Practice E-Tips on Billing and Collections - 12/19/2017

Practice E-Tips on Billing and Collections


Practice e-Tips on Reimbursement - 12/13/2017

Billing & Fees Claims Coding & Documentation Collections Copayments & Deductibles Medicaid & Medicare Workers' Comp Billing & Fees Are You Missing Out on Your Money?    Billi


Payer Roundup, October 2017 - 11/06/2017

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. See a reminder about your Physician Compare review, and find out about certain claim rejections, and new health plans and policies  


Payer Roundup, September 2017 - 09/29/2017

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. Find out about a physician ranking deadline, new policies and guidelines, dispute process rules, and more.


Commercial Risk Adjustment: One More Reporting Requirement - 07/28/2017

As part of Aetna’s commercial risk management initiative, a medical records vendor will contact you twice this year on behalf of Aetna. Here are some details about this process, required for all payers.


Private Payer Roundup, May 2017 - 05/26/2017

In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. Find out about new preauthorization requirements, new web tools, policy changes, and more.