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.
Guide to Insurance Overpayments and Refund Requests - 04/29/2019
Use this guide to help you and your staff properly assess refund requests from health plans.
Most Valuable Team: Managing Nonphysician Staff Efficiently Can Boost Patient Care and Bottom Line - 04/17/2019
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.
Starting a Practice - 04/16/2019
Setting Up or Closing a Practice
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.
Watch Those Extra Fees For Medicare Patients - 03/04/2019
Watch Those Extra Fees For Medicare Patients
Correct Coding Initiative Edits Now Free on Internet - 03/04/2019
Correct Coding Initiative Edits Now Free on Internet
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.
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.
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.
SB 418: Prompt Pay Final Rules - 01/24/2019
SB 418: Prompt Pay Final Rules
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.
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.
Sharing is Caring? Health Care Sharing Ministries Cause Confusion - 12/07/2018
Confusion surrounding health care sharing ministries puts Texas Medical Association on alert.
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.
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.
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.