Stark generally prohibits a physician (or an immediate family member of such physician) who has a direct or indirect financial relationship with an entity that provides a designated health service from making a referral for that service for which Medicare or Medicaid would otherwise pay. This very broad prohibition is mitigated by a large number of exceptions. These exceptions must be met exactly. Failure to meet a Stark exception will result in a violation.

When Should We Write Off Large Patient Balances? - 11/12/2025

Is there a formula to calculate the net present value for the balance of a patient’s account compared with a small monthly payoff?

Develop a No-Show Policy — and Use It - 11/12/2025

Develop a no-show policy — and use it

Collection Agency Submittal Do’s and Don’ts - 11/11/2025

Your collection agency has a better shot at success in collecting your past-due accounts if you follow tips for submitting accounts to the agency.

Use These Four Steps With Irate Patients - 11/11/2025

When faced with a highly emotional patient, your first task is to lower the emotional level of the patient so you can negotiate a reasonable solution. Use these four steps to accomplish that.

Patient Notification During Practice Transition - 11/11/2025

Patient Notification During Practice Transition

Starting a Practice - 11/11/2025

Setting Up or Closing a Practice

Verify Auditor Credentials - 11/11/2025

Be careful about who gets access to your medical records, and to which ones.

Solve Conflict With These Four Steps - 11/10/2025

When patients’ emotions are high, their logic is low. To solve a conflict with a patient, you need lower the patient’s emotional level so you can negotiate a reasonable solution.

Appealing Claims Can Have Appealing Results - 10/24/2025

Not appealing inappropriately paid or denied health plan claims can be quite costly to your practice. Here’s why.

Medicare as Secondary Payer - 10/24/2025

Medicare as secondary payer: Submit the primary EOB with paper claims but not with electronic claims.

You Can Get Paid for Medicaid Emergency Services - 10/24/2025

You Can Get Paid for Medicaid Emergency Services

Follow These Five Tips When You Follow Up on Claims - 10/24/2025

Follow These Five Tips When You Follow Up on Claims

Practice e-Tips on Reimbursement - 10/22/2025

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

Practice e-Tips on Claims - 10/20/2025

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

Should You Bill This Visit as “Incident to”? - 10/16/2025

A physician hires a nonphysician practitioner and establishes a standing delegation order for a specific course of treatment. … Read the rest of the scenario. Can you answer the billing question correctly?

TMA Reimbursement Services - 09/22/2025

TMA Payment Advocacy Services

It Takes a Team to Produce a Good Claim - 09/16/2025

It Takes a Team to Produce a Good Claim

Four Bill-Collecting Tips for New (or Any) Practices - 09/16/2025

Starting a practice can be daunting, and one challenge often overlooked is making sure you get paid. Although only a small number of patients will not pay you, or will pay slowly, they can hurt your bottom line. Writing off thousands of dollars in charges should not be an option.

What's My Taxonomy Code? - 09/15/2025

What's My Line (Taxonomy Code)?

Novitas Clarifies Payment Available for ‘Buildup Phase’ of Allergy Treatments - 09/12/2025

The Medicare administrative contractor confirmed their payment policy at a meeting with TMA. Members should contact the association’s Physician Payment Resource Center if claims denials occur.

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