Related Stories

Payers Axe Consultation Codes - 08/07/2019

Both Cigna and UnitedHealthcare (UHC) have announced that starting in October, they will no longer pay for CPT consultation codes 99241-99245 – office consultations – and 99251-99255 – inpatient consultations. UHC’s policy change becomes effective Oct. 1, as outlined in its March bulletin. Cigna’s July newsletter says Cigna’s policy takes effect Oct. 19.


Most Valuable Team: Managing Nonphysician Staff Efficiently Can Boost Patient Care and Bottom Line - 08/02/2019

Because state laws and insurer billing requirements governing physician delegation and supervision can be tricky to navigate, practices must stay up to date to avoid potential penalties.


Get Dates of Service Right on Medicare Claims - 05/30/2019

When you a perform a Medicare service that is global, has both a professional and a technical component, or spans days or months, you need to know what date Medicare considers to be the official date of service when you file your claim. Here is some guidance from the Centers for Medicare & Medicaid Services (CMS) about coding and billing dates of service on professional claims.


Use Modifiers to Override Correct Coding Initiative Edits - 05/28/2019

Correct Coding Initiative Edits Now Free on Internet


Medicare X{EPSU} Modifiers Further Define Modifier 59 - 05/24/2019

The Centers for Medicare & Medicaid Services has established four new modifiers to define subsets of the commonly — but often mistakenly — used modifier 59.


Medicare Critical Care and Initial Hospital Services E and M Slated for Review - 05/17/2019

If you’ve been “probed and educated” twice by Novitas Solutions Inc. for high rate of claims errors regarding certain evaluation and management (E&M) services, you may receive more such review and education this summer.


Code Carefully for Bilateral Procedures - 05/02/2019

Coding for bilateral procedures can be confusing. Many payers accept CPT modifier 50 as an indicator of a bilateral procedure, but they differ in how they apply it to their coding and payment policies.


Your EHR Vendor Is Not Responsible For Your Security Risk Analysis - 03/11/2019

A Security Risk Analysis is a living document that should be reviewed at least annually to find new vulnerabilities, such as new technology, system upgrades, and any other changes within your practice that could affect the security of protected health information.


Use New G Codes for Medicare Therapy Claims - 03/04/2019

Starting with services dated Jan. 1, 2013, physicians have to report new, nonpayable G codes and related modifiers on Medicare claims for outpatient physical, speech, and occupational therapy.


Coding Changes Affect UnitedHealthcare Prior Authorization Lists - 02/22/2019

UnitedHealthcare (UHC) has replaced and added procedure codes on its notification and prior authorization (PA) lists.


Revenue Cycle Assessment - 02/11/2019

A TMA consultant will conduct a review of your business office operations that focuses on front desk procedures, billing, collections and revenue cycle improvement. We will identify opportunities for improvement of billing processes and procedures.


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.


Use Transitional Care Management CPT Codes - 01/10/2019

Two new CPT codes for transitional care management services are in effect, and Medicare accepts them. But read the Medicare rules carefully because they vary from the CPT guide.


Good-bye Strips, Hello Chips - 01/10/2019

Get your practice ready for changeover this year to new microchip-embedded debit and credit cards, or assume liability for any fraudulent transactions.


Human Resources Consulting Services - 12/19/2018

Would you like help with realigning staff duties, defining staff roles, streamlining work flow, and determining the most efficient staffing level for your practice? TMA Practice Consultants can help.


Coding and Documentation Review - 12/19/2018

An in-depth review of medical record documentation and claims coding that identifies deficiencies and areas of risk. This review will help streamline coding and documentation processes and decrease the risk of external audits.


Practice Check-Up - 12/12/2018

An overview of practice operations and financial analyses designed for small practices (one to three physicians) that includes gross charges, gross collections, adjusted collections, and accounts receivable. This will provide a “snapshot” of your practice’s daily processes and current financial health.


TMA Case Study: Coding and Documentation - 10/05/2018

TMA’s certified professional coders and auditors can help protect your revenue by performing an in-depth review of how your practice documents medical records and codes claims. The review helps streamline coding and documentation processes, and decrease the risk of external audits.


United to Add Lab, Change Lab and Other Policies - 10/04/2018

Starting Jan. 1, 2019, UnitedHealthcare will use Quest Diagnostics, in addition to LabCorp, as in-network laboratories for all UHC members (excluding existing lab capitation agreements).


Responsibility for Coding - 09/18/2018

Remember, physicians ultimately are responsible for choosing which code s the practice bills to insurance carriers.


What To Do When Employees Steal: Medical Practices Are a Ripe Target for Embezzlement - 09/14/2018

Medical practices are a ripe target for embezzlement.


Let TMA Help You Optimize Your Revenue Cycle - 09/12/2018

Is your practice struggling to collect payments? Are your accounts receivable growing rapidly? Is there a drain on your bottom line? The culprit could lie in your revenue cycle management.


Humana Physician Portal to Retire in October - 08/27/2018

Humana will shutter its secure provider portal on Oct. 3. To continue or begin working with Humana online, prepare now by registering for the Availity Provider Portal if your practice doesn’t already have an account.


How to Bring Down Your No-Show Rate - 08/16/2018

Are no-show patients a big problem at your practice? Here is how one practice cut its no-show rate steeply.


10 Common Ways Your Practice Could Be Leaking Money - 07/12/2018

Think of your revenue cycle like a pipeline that moves from patient scheduling, to billing and collections, and finally to deposits in the bank. Here are five common ways your practice may be losing revenue.