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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?

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.

Starting a Practice - 06/03/2024

Setting Up or Closing a Practice

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.

Medicare Sunsets Beleaguered Appropriate Use Criteria Program - 03/14/2024

After longstanding opposition from the Texas Medical Association and others, the Centers for Medicare & Medicaid Services finally nixed the appropriate use criteria program for advanced diagnostic services as part of the 2024 Medicare physician fee schedule.

Physicians May Face Lower Payment as CMS Resumes Lab Data Collection - 03/11/2024

The Centers for Medicare & Medicaid Services will continue to collect data from physician-owned laboratories to inform private payer rates despite pushback from the Texas Medical Association.

Revenue Cycle Assessment - 01/22/2024

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.

Practice Operations Services - 01/22/2024

With the many challenges that face today's medical practices, business operations remain at the core of a practice's ability to be successful and profitable. Work with a TMA practice management consultant to identify and assess key or problematic areas of your practice.

Financial Management Services - 01/22/2024

Having sound financial policies and processes can help your practice attain a steady cash flow, maintain healthy collection ratios, increase staff efficiencies, and boost your overall bottom line.

Spending Growth Rate for Physician Services Slows - 01/09/2024

Although spending on physician and clinical services increased 2.7% year-over-year to $884.9 billion in 2022, the spending growth rate fell, due in part to a slowdown in the use of such services and in physician prices. In comparison, spending on physicians and clinical services grew 5.3% in 2021.

Bipartisan Legislation Would Prohibit Electronic Funds Transfer Fees - 12/08/2023

Recently introduced federal legislation could spare physicians from electronic funds transfer (EFT) fees, which payers routinely charge as a condition of electronic payment.

How to File a Medicare Extended Repayment Plan - 12/06/2023

  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. 

CMS Strengthens Price Transparency for Hospitals - 11/29/2023

A new Centers for Medicare & Medicaid Services final rule aims to strengthen hospital price transparency regulations for 2024, a move physicians hope will address weaknesses in prior policy that hindered them and patients from making informed health care decisions.

TMA Pushes for Elimination of Excessive Electronic Funds Transfer Fees - 09/22/2023

Payers routinely charge physicians the fees as a condition of electronic payment, often without consent. Alongside declining physician payment, the fees add to the threat to practice viability, and ultimately patients’ access to care. Read more.

Three Ways to Achieve Four Important Fee Schedule Traits - 08/30/2023

By paying careful attention to your practice fee schedule, you’ll not only ensure you are getting paid insurers’ allowable charges but you also may help make sure health plans pay you on time.

Here’s What Medicare Pays for Flu Shots This Season - 08/23/2023

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.

Is Medicare’s Chronic Care Management Program for You? - 08/21/2023

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.

CMS to Recoup Chronic Care Management Payments - 08/21/2023

Some Texas physicians and outpatient facilities might have to refund payments they received for chronic care management services performed during 2015 and 2016 under the Medicare Physician Fee Schedule, federal officials said.

Don’t Forfeit Your APM Incentive Payment; Act Now - 08/14/2023

If you participated in an advanced alternative payment model in the 2021 Quality Payment Program and haven’t yet received your 2023 incentive payment, you have until Sept. 1 to update your billing information – or forfeit the payment.

Preauthorization Denial: What’s Your Recourse? - 07/25/2023

So a health plan has denied your preauthorization request for a patient’s treatment. What options do you have?