Related Stories

TMA Urges District Court AGAIN to Protect Patient Access in “No Surprises Act” Final Rules - 12/02/2022

The Texas Medical Association (TMA) today announced it has filed a new lawsuit in the U.S. District Court for the Eastern District of Texas, challenging certain portions of the Aug. 26, 2022 final rules implementing the federal No Surprises Act (NSA). This is the second time in less than a year TMA has filed a lawsuit against federal agencies related to rulemaking under the law.

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.

TMA Seeks to Protect Patients’ Access to Care in New “No Surprises Act” Rules Lawsuit - 12/01/2022

Amid concerns about threats to patients’ access to physicians’ care, the Texas Medical Association (TMA) has filed a new lawsuit in the U.S. District Court for the Eastern District of Texas, challenging certain portions of the July 2021 interim final rules implementing the federal No Surprises Act (NSA). This is the third lawsuit TMA has filed against federal agencies related to rulemaking under the law.

Deal or No Deal: Negotiating Contracts - 11/28/2022

Maximize your leverage when negotiating a health plan contract.

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.

Blues to Expand HMO Network in January; Check Your Status - 10/21/2022

Blue Cross and Blue Shield of Texas (BCBSTX) will expand its MyBlue Health HMO network to six Texas counties starting in January.

TMA: No Government Price Controls for Out-of-Network Billing Disputes - 10/13/2022

The government shouldn’t set the fees physicians are paid for out-of-network care. That’s the message the Texas Medical Association is sending to key members of the U.S. Senate as lawmakers consider a troubling federal bill.

TMA President: Rulemaking on Surprise Billing Must Be Fair to Docs - 10/08/2022

Now that the Texas Legislature has passed a measure to counteract surprise billing involving many state-regulated plans, it’s time for rulemaking. The Texas Medical Association is working to make sure the Texas Department of Insurance’s eventual rules borne out of Senate Bill 1264 will give physicians a fair shake.

Panel Makes Big Change in Draft Federal Surprise Billing Law - 10/08/2022

Thanks to incessant lobbying from physicians, hospitals, organized medicine, and the Physicians Advocacy Institute, a key congressional committee today made significant revisions in a bill to reduce the strain of surprise billing on patients. “This certainly sounds like an improvement,” said Texas Medical Association President David Fleeger, MD, “but the devil will be in the details.”

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.

United Overpayment Notices Go Paperless as of Sept. 23 - 09/07/2022

Beginning Sept. 23, UnitedHealthcare will no longer mail overpayment notification letters for most of its Medicare Advantage and commercial health plans, shifting them instead to its digital portals.

Sponsored Content: Get Group PPO Health Insurance – Without Employees - 08/23/2022

You know that if you’re an independent practice owner with employed staff, group PPO health insurance is an option for you. But what if for you, practicing as an independent physician means you are truly independent, with no employees?

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?

Health Insurers Now Required to Post Comprehensive Price Data - 08/01/2022

Physicians, patients, and employers have long wondered whether they’re getting a fair shake from health insurers, whose prices have been clouded in secrecy – until now.

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.

Cigna Delays Records Request Policy, Staving Off “Administrative Nightmare” - 06/29/2022

Cigna has delayed the implementation of a new billing policy after the Texas Medical Association and others in organized medicine pushed back, warning that it would have negative implications for physicians, practice staff, and patients.

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.

Cigna to Request Records for Certain Office Visits, Unleashing Possible “Administrative Nightmare” - 05/26/2022

Cigna recently began alerting physicians to a new billing policy that could have far-reaching consequences for Texas physicians, practice staff, and patients.

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.

Turn to TMA to Resolve Insurance Hassles - 05/19/2022

If you or your practice is dealing with prompt-pay or other health plan problems, the Texas Medical Association can help resolve those issues through TMA’s Reimbursement Review and Resolution Service. The Texas Department of Insurance last week released a bulletin reminding plans that a portion of prompt-pay penalties must be paid to the state.

Feds Finally Open Dispute Portal Under Surprise-Billing Law - 04/20/2022

Physicians needing to formally settle a dispute with insurers over certain out-of-network payments under the federal No Surprises Act finally can initiate that process online.