Related Stories

Preauthorization Denial: What’s Your Recourse? - 10/16/2020

So a health plan has denied your preauthorization request for a patient’s treatment. What options do you have?


TMA: Fair Telemedicine Payments will Ensure Patients’ Care Continues - 09/25/2020

Statement by Texas Medical Association (TMA) President Diana L. Fite, MD, regarding Gov. Greg Abbott’s announcement today that Texas’ state-regulated health plans will continue to pay physicians and health care providers the same rate for patients’ telemedicine care as for in-person care, through the end 2020.


Don’t Miss New and Revised LCDs - 08/13/2020

Take a look at these new and revised Medicare local coverage determinations (LCDs) and article updates from Novitas Solutions. Remember, Novitas will reject claims that don’t adhere to LCDs.


E&M Coding About to Change - 08/03/2020

First, the bad news: Physicians need to take some serious time between now and Jan 1, 2021, to study changes that are coming to Medicare outpatient evaluation and management (E&M) codes – changes most private insurers likely will follow. Now the good news: The changes should reduce the amount of documentation needed with each patient.


Take Our Billing and Coding Quiz - 07/17/2020

TMA Knowledge Center staff fields hundreds of questions about coding and billing from TMA members. Here are a few FAQs. Do you know the answers to these questions?


Invoice No Longer Required for Some Medicare Claims - 06/03/2020

For certain biologicals and medications reported in Medicare Part B claims, Novitas Solutions now will allow you to enter invoice information on the claim, rather than provide the actual invoice for the services.


You May Need to Refile Some Medicare Claims - 02/03/2020

Be on the lookout for Medicare claims you’ve filed since Oct. 1 in which procedure codes failed to process, causing a rejected claim. You will need to refile these claims.


Insurance Companies Have Denied My Doctor’s Orders, 25% of Texas Voters Say in New Poll - 01/29/2020

One in four Texas voters say their health insurance company has refused to cover what their physician ordered for them or their families, a new statewide survey has found.


Is Medicare’s Chronic Care Management Program for You? - 11/22/2019

Interested in the possibility of getting paid as much as $75,000, or even more, for something you already more or less do? Medicare now pays separately for chronic care management services. To help you decide if this new opportunity is right for your practice, TMA created a new online resource center.


Chronic Care Management: The Patient Agreement - 11/22/2019

Securing a patient’s informed and written consent is an important part of the Medicare Chronic Care Management Services program. Medicare requires it, and you’ll be sure your patients understand how it works.


Examine the Billing Cycle “Vitals” for Your Practice - 11/13/2019

The Texas Medical Association’s free webinar, What You Need to Know to Evaluate Your Billing Process, offers a step-by-step process and tools to assess your practice’s financial health and identify key areas for improvement. The webinar will show you how to use practice management reports to evaluate your staff’s productivity, your billing and collections processes, and even payer performance.


Medicare Lab Fee Includes Routine Venipuncture - 10/16/2019

If you perform the lab test in your office, you may not bill separately for the “collection of venous blood by venipuncture,” or CPT code 36415, according to the Medicare Claims Processing Manual. However, a significant number of physicians who collect blood and perform lab tests in their office are billing for CPT code 36415 along with the test code, the Center for Medicare & Medicaid Services says.


Here’s What Medicare Pays for Flu Shots This Season - 10/04/2019

The Centers for Medicare & Medicaid Services recently published 2019-20 payment rates for personal flu vaccines and their administration. The effective dates for these rates are Aug. 1, 2019, to July 31, 2020.


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.


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.


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.


Low-Cost Counseling Available for Harvey Victims - 01/23/2019

It’s been almost 18 months since Hurricane Harvey battered the Texas coast, but its effects are still being felt, particularly in the mental health of people affected by the storm. Thanks to a grant from Rebuild Texas Fund, the Texas chapter of the National Association of Social Workers is offering free or low-cost counseling services for storm victims.


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.


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.


Help Your Colleagues Affected By Hurricane Florence Rebuild - 09/27/2018

Many Texas physicians found themselves in desperate financial need last year when flooding from Hurricane Harvey wiped out homes, businesses, and practices along the Gulf Coast. Now it’s Texas physicians’ turn to help their colleagues who have been affected by Hurricane Florence, which has caused severe flooding in parts of North Carolina, South Carolina, and Virginia.


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.


Feds Award More Than $10 Million to Harvey-Affected Health Centers - 09/10/2018

Thirty two Texas community health centers received almost $10.4 million on Thursday to help offset the effects of Hurricane Harvey last year. The U.S. Department of Health and Human Services (HHS) awarded the funds to help health centers nationwide.


How Did the Health Department Do During Harvey? - 09/07/2018

When Hurricane Harvey blew ashore along the Texas coast in August 2017, the Texas Department of State Health Services was on the front line responding to the storm. So how did the state's health agency acquit itself? The DSHS "after-action report" released last week spells out the department's successes and shortcomings.


Hurricane Harvey: The Way Back - 08/27/2018

Lessons learned as practices emerge from Harvey’s wrath.


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.