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Texas Medicare Contractor Answers Critical Care Coding Questions - 05/25/2022

Confused about how to quantify critical care services or delegate such services to nonphysician practitioners? You’re in luck.


Practice e-Tips on Practice Operations - 05/25/2022

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


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.


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.


Reminder: Provider Relief Fund's Second Reporting Period Ends March 31 - 03/28/2022

If you received Provider Relief Fund distributions greater than $10,000 from July 1, 2020 to Dec. 31, 2020, this Thursday, March 31, is your deadline to report how you used those funds.


MIPS Deadlines Approaching for 2021 Data Submission, COVID Exception - 03/28/2022

Clinicians who participated in Medicare’s Merit-Based Incentive Payment System (MIPS) in 2021 have until this Thursday, March 31, at 7 pm CT to submit and update their data for that performance year. That's also the deadline for MIPS-participating groups, virtual groups, and alternative payment model entities to apply for an extreme and uncontrollable circumstances exception for 2021 because of COVID-19.


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.


Out-of-Network and What It Means - 03/03/2022

A physician is out-of-network when a contract has not been established with a health plan. Get tips on what to do when providing services to out-of-network patients.


Practice e-Tips on Reimbursement - 03/03/2022

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


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.


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.


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.


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.


Late Fees Under Prompt Pay — How Much and When - 11/17/2021

Let’s say your contracted insurance carrier violates prompt pay laws and misses the deadline for paying or responding to your claim. When can you collect late fees and how much?


Preauthorization: What If the Diagnosis Changes? - 11/17/2021

Can the carrier deny payment for services performed to treat the final diagnosis? Can it refuse to pay for some of the inpatient days it initially authorized?


Sample Letter: Enlisting Patients Assistance for Claims Payment - 11/17/2021

This is a sample letter regarding a patient's outstanding health insurance payment.


The Service Is Verified; Do I Need to Send a Clean Claim? - 11/17/2021

The Service Is Verified; Do I Need to Send a Clean Claim?


Correct Code for Billing a Routine Venipuncture - 11/17/2021

Learn the correct code for billing a routine venipuncture.


Filing a Compliant With the Texas Department of Insurance (TDI) - 11/17/2021

Filing a Compliant With the Texas Department of Insurance (TDI)


At-a-Glance Billing Guidelines - 11/17/2021

At-a-Glance Billing Guidelines