Related Stories

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?


Practice E-Tips on Billing and Collections - 07/17/2020

Practice E-Tips on Billing and Collections


Hassle Factor Log Program User Information - 06/30/2020

Hassle Factor Log Program User Information


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.


Watch Out For COVID-19 Cyber Scams - 03/20/2020

Internet scammers are trying to cash in on the widespread anxiety over COVID-19, and awareness is the best defense, according to the U.S. Cybersecurity and Infrastructure Security Agency. Likewise, the Texas Attorney General's Office has issued a warning about outbreak-related scams.


Beware of Phony TMB or DEA Agents - 02/05/2020

The Texas Medical Board (TMB) is warning physicians and pharmacies of a scam involving criminals who sometimes pose as TMB officials. TMB passed along a report from the U.S. Drug Enforcement Administration (DEA) that says physicians registered with the DEA are receiving calls and emails from criminals who identify themselves as DEA personnel or other law enforcement agents.


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.


Microsoft Windows, Server Systems Vulnerable to Hackers, Feds Warn - 01/17/2020

Texas physicians should look out for a security weakness in Microsoft Windows 10, Server 2016, and Server 2019, the Department of Homeland Security (DHS) said this week.


Develop a No-Show Policy — and Use It - 12/12/2019

Develop a no-show policy — and use it


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.


Practice e-Tips on Claims - 10/30/2019

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


Starting a Practice - 10/30/2019

Setting Up or Closing a Practice


Ousting the ‘F-Word’ From Your Practice - 10/29/2019

You do everything you can to keep your patients safe and healthy. But are you sure your practice is safe from fraud and abuse? Don’t wait for a costly government audit – or a criminal charge – to come knocking. Check out the Texas Medical Association’s e-book, Fraud and Abuse Prevention Simplified, which can help you learn to protect both your practice and patients.


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.


Medical Devices Could Be Vulnerable to Hackers, FDA Warns - 10/02/2019

Certain medical devices and hospital communications networks could contain cybersecurity vulnerabilities that could allow a remote attacker to take control of the device and change its function, the Food and Drug Administration (FDA) warned on Tuesday.


Beware of Scam Email Sent to TMA Members - 08/21/2019

An unauthorized email that claimed to be from the Texas Medical Association recently was sent to some TMA members stating that the individual member’s dues statement and insurance policy update was included. If you received this email, please know that it did not originate from nor was it authorized by TMA or the TMA Insurance Trust, and you should discard it.


Guide to Insurance Overpayments and Refund Requests - 08/14/2019

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 - 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.


Scammers Targeting Texas Pulmonologists Seeking $500 - 06/19/2019

The Texas Medical Association is warning pulmonary physicians to be aware of a scam involving a letter from a phony medical board that seeks $500 “for Pulmonary Disease Certification Status Verification.” Two Texas pulmonologists contacted TMA to report a letter from the “American Board of Pulmonary Disease” notifying them of a “very important requirement to continue certification in pulmonary disease at this time. You are on record having failed to previously register, and must comply.”


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.