Related Stories

Texas Blues Reverses Policy to Discontinue Incident-To Billing - 05/13/2022

In response to Texas Medical Association advocacy, Blue Cross and Blue Shield of Texas (BCBSTX) has reversed a new policy under which the insurer would have discontinued paying the full payment rate for “incident-to” services performed by nonphysician practitioners (NPPs).


Hospital Ownership the Focus of New Medicare Report - 05/09/2022

In an effort to analyze the impact of consolidation within the health care system, Medicare for the first time has released data on mergers and acquisitions for enrolled hospitals and nursing homes between 2016 and 2022. The action follows up on the Biden Administration's Executive Order on Promoting Competition.


Delay Upcoming Medicare Cut, TMA Tells Congress - 04/08/2022

With just days remaining until the latest Medicare physician pay cut takes effect, the Texas Medical Association has been lobbying for an eleventh-hour act of Congress to stop it.


Medicare Lowers Thresholds to Cover Lung Cancer Screening - 04/05/2022

Medicare has announced expanded coverage for lung cancer screening using low-dose computed tomography, the only recommended screening test for the disease.


MIPS Participation Drops per Preliminary Report - 04/05/2022

Fewer clinicians participated in Medicare’s Quality Payment Program in 2020, and fewer participants earned incentive payments compared with 2019, according to preliminary data recently released by the Centers for Medicare & Medicaid Services.


Federal Surprise Billing Law in Effect: Get Educated - 04/05/2022

Despite ongoing litigation over certain aspects of the federal surprise billing law, the patient protection components of the No Surprises Act still took effect at the beginning of the year. With them come a number of changes that could significantly impact physician practices now that balance billing is largely prohibited.


Health Plans Not All Recognizing New Telehealth Code - 04/05/2022

A new telehealth code and a series of coding modifier descriptors have already taken effect in 2022 or will take effect soon. But not all health plans are recognizing the new coding elements, according to Texas Medical Association staff monitoring their status.


AMA Updates Estimated Medicare Payment Impacts - 04/05/2022

Following medicine’s fervent advocacy in late 2021 that convinced Congress to stop almost all of a nearly 10% Medicare physician pay cut for 2022, the American Medical Association has released an updated analysis on Medicare payments by specialty for this year.


A Long-Overdue Fix: Comprehensive Medicare Reform Could Halt Pay Cuts - 03/31/2022

Physicians say Medicare reform is the only solution to the problem of periodic pay cuts  – and they’re prepared to fight for it.


Practice e-Tips on Practice Operations - 03/18/2022

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


Practice E-Tips on Billing and Collections - 03/18/2022

Practice E-Tips on Billing and Collections


Guide to Insurance Overpayments and Refund Requests - 03/18/2022

Use this guide to help you and your staff properly assess refund requests from health plans.


Congress Scraps Most of Medicare Cuts, Heeding Medicine’s Warnings - 03/08/2022

The Texas Medical Association and many others in organized medicine bellowed through a collective bullhorn, urging Congress to pull Medicare physician payments back from the brink.


Here’s Your Billing and Collections Checklist for 2022 - 02/14/2022

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 2022 to keep your billing and collections on track throughout the year.


Four Bill-Collecting Tips for New (or Any) Practices - 02/01/2022

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.


TMA: Thanks for Saving Medicare; More Work Ahead - 01/14/2022

Statement by Texas Medical Association (TMA) President E. Linda Villarreal, MD, in reaction to Congress passing legislation Thursday averting most of a 9.75% Medicare cut to physician payments, which was scheduled to take effect on Jan. 1, 2022.


The X{EPSU} Modifiers Further Define Modifier 59 - 12/27/2021

Modifier 59, the distinct procedural service modifier associated with Medicare National Correct Coding Initiative edits, is one you might find confusing (many practices do). Follow these guidelines


Practice e-Tips on Medicare - 12/03/2021

Get practice tips on all things Medicare. Learn what Medicare requires for enrollment, participation, billing, claims, coding, documentation, and more.


Know State and Payer Rules for Clean Claims - 12/03/2021

Filing a clean claim gives you protections under Texas’ prompt pay law. For a claim to be “clean” you don’t have to fill out every field on the claim form, just the right ones.


TMA Ask the Expert: Medicare Physician Fee Schedule - 12/02/2021

The Centers for Medicare & Medicaid Services’ (CMS’) 2022 Medicare Physician Fee Schedule takes effect on Jan. 1 and raises several concerns for physicians treating Medicare patients, including a series of mandated pay cuts totaling nearly 10% and changes to the already complex Quality Payment Program (QPP).


Changing Your Medicare Participation Status for 2022 - 11/30/2021

The Texas Medical Association is still working to convince Congress to stop several cuts for 2022 payments for Medicare physician services that would total nearly 10%. But with those cuts still going into effect as of now, you may wish to modify their Medicare participation status.


Congressional Members Support Halt to Medicare Cuts - 11/28/2021

Two physician members of Congress are echoing the Texas Medical Association’s call for lawmakers to stop pending Medicare physician pay cuts totaling nearly 10%, and their push has the support of hundreds of members of the House of Representatives.


Coding a Cancelled Procedure - 11/19/2021

How do we code a cancelled procedure, for example when a patient’s vital signs preclude continuing the procedure?


Instructions for Deleting Data Elements on NPI Applications - 11/19/2021

Step-by-step instructions to delete data elements on NPI applications


How to Calculate Underpaid Amount in Prompt Pay Rules - 11/17/2021

Even if the insurance company pays on time but underpays you - if it doesn't pay in full by the statutory deadline, it still must pay you a penalty based on the number of days the payment is late and the underpaid amount of the claim.