Related Stories

VA Seeking Refunds from Physicians for Past CHAMPVA Claims - 06/26/2025

Physicians may soon hear from the U.S. Department of Veterans Affairs (VA) seeking refunds for payments it says were made in error. TMA has provided information on what steps physicians may take.

Service Provider: TMA Practice Resources Educate Physicians on Practice Challenges - 06/23/2025

TMA’s robust practice resources help educate physicians on common billing issues, payer updates, and practice challenges.

How to Set a Standard Fee Schedule for Your Practice - 06/16/2025

 You have complete authority and responsibility to set your own standard practice prices. When you set your fees, consider basic business principles, including profit, return on investment, competition, and marketing.  

Practice e-Tips on Claims - 05/29/2025

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

Practice e-Tips on Coding - 05/29/2025

Get practice tips on all things coding. Learn about coding methods, correct coding, resources, coding related to Workers' Comp and more.

Why You Need Business Associate Agreements - 05/07/2025

A medical practice in Illinois in April paid a $31,000 fine because it didn’t have a business associate agreement (BAA) with one of its long-time vendors. Any chance your practice has overlooked signing a BAA with any of its business associates?

What Are HIPAA Transaction and Code Sets Standards? - 03/20/2025

Learn about the HIPAA Transactions and Code Sets Rule that standardizes electronic data interchange (EDI) transactions for submitting, processing, and paying claims. Has your practice met the required standards?

Practice E-Tips on Billing and Collections - 03/19/2025

Practice E-Tips on Billing and Collections

Why You Need a Written Payment Policy - 03/19/2025

If your practice is wishy-washy about your payment policy, you essentially are allowing each patient to make his or her own policy. What other business allows its customers to decide when and how they will pay?

20 Everyday HIPAA Tips - 03/17/2025

 The goal of HIPAA is to make sure the protected health information you are responsible for or come into contact with remains confidential, secure, and available when you need it. Here are basic steps every practice can take to help make this happen.  

Practice e-Tips on Practice Operations - 03/17/2025

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

Don’t Overlook Credit Card Processing Fees - 02/14/2025

In today’s world of coinsurance and high-deductible health plans, more of a practice’s revenue comes from the patient, and taking credit cards has become a must. But are you paying too much for credit card processing services?

Aetna Reverses NPP Payment Reduction Under Incident-To Billing - 02/12/2025

Aetna previously intended to pay nonphysician practitioners (NPPs) 85% of the allowable amount, regardless of whether they billed directly or “incident-to” a physician’s diagnosis and treatment. Meanwhile, the payer upholds a new credentialing requirement.

Practice e-Tips on Reimbursement - 01/28/2025

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

Your Billing and Collections Checklist for 2025 - 01/10/2025

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 2024 to keep your billing and collections on track throughout the year.

TMA to Represent Texas Physicians’ Coding, Payment Concerns on National Credentialing Organization - 12/17/2024

TMA’s Director of Physician Payment Services has been appointed to the former Academy of Professional Coders’ National Advisory Board, where she will elevate the voices of Texas physicians through collaboration on coding, billing, and compliance issues.

FTC Mandates Vendors Notify Patients of Breaches in Health Information - 11/07/2024

The Federal Trade Commission has amended its Health Breach Notification Rule to require vendors of personal health records and related entities not covered by HIPAA to notify individuals, the FTC, and, at times, the media, when a breach in protected health information occurs. The change will take effect July 29.

Code Carefully for Bilateral Procedures - 10/02/2024

Coding for bilateral procedures can be confusing. See how payers differ in how they apply CPT modifier 50 to their coding and payment policies.

BCBSTX to Require E/M Codes for Consultation Services - 09/03/2024

Starting Nov. 18, Blue Cross and Blue Shield of Texas will no longer pay physicians for outpatient or inpatient consultations when they report those services with Current Procedural Terminology codes 99242 – 99245 and 99252 – 99255.

Coding with Care: Knowing Billing Codes for Complex Care Can Maximize Revenue, Access to Care - 08/28/2024

Knowing billing codes for complex care can maximize revenue and access to care.

Physicians Can Delegate Breach Notifications to Change Healthcare Following Cyberattack - 06/26/2024

The U.S. Department of Health and Human Services’ Office of Civil Rights announced  May 31 that covered entities – such as health plans, health care clearinghouses, and physicians – affected by privacy breaches stemming from the February cyberattack on Change Healthcare and its parent corporation UnitedHealth Group may delegate breach notifications to both companies.

G-Code Payment Frustration Persists With Inconsistent Implementation - 06/25/2024

Deepening ongoing physician concerns over Medicare’s add-on code for complex care, two major payers have either reduced payment for G2211 claims or announced plans to stop paying certain claims associated with the code altogether. Read more.

Starting a Practice - 06/03/2024

Setting Up or Closing a Practice

Cigna to Deny Claims Without Z-Code Documentation - 04/24/2024

Starting July 14, Cigna Healthcare will deny certain claims that are billed with a Z code and without documentation, a move that could add to physicians’ administrative burden.

Medicare May Seek Payment Recoupment for 2023 Claims - 04/09/2024

A new report by the Government Accountability Office shows physicians may face possible recoupments – or additional payment – for claims filed in 2023 as a result of over and underpayments by Medicare, Medicaid, and other federal programs.