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Medicine Urges Cigna to Withdraw Far-Reaching Modifier 25 Policy - 05/03/2023

Demonstrating the far-reaching impact of a new Cigna policy, the Texas Medical Association joined organized medicine and other health professionals in collectively and vociferously calling on the payer to “immediately rescind” an onerous requirement for additional documentation for routine, minor procedure claims starting in June.

Congress Weighs Legislation Tying Medicare Physician Payments to Inflation - 04/26/2023

Heeding advocacy by the Texas Medical Association and others in organized medicine, Congress is weighing bipartisan legislation that would index Medicare physician payments to inflation, overriding cuts scheduled to take effect in 2024.

Update: New Cigna Policy Requires Additional Documentation for Same-Day Procedures - 04/03/2023

Despite medicine’s pushback, Cigna plans to move forward with burdensome billing policy requiring additional documentation for routine, minor procedure claims starting in June.

TMA to Congress: Tie Medicare Physician Payment to Inflation - 03/29/2023

As part of a broader push for Medicare payment reform, the Texas Medical Association, along with the American Medical Association and 133 national specialty and state medical associations, recently called on Congress to index Medicare physician payments to inflation.

Labs – Including Those Run by Physicians – Face New Reporting Requirement in 2023 - 03/14/2023

Starting Jan. 1, medical laboratories – including physician-owned labs – face a reporting requirement from the Centers for Medicare & Medicaid Services that will create a paperwork burden and could negatively affect payment rates.

Prevent Improper Code Bundling With New Medicare Tool - 02/15/2023

Physicians can take advantage of a new Medicare tool to sort through the thousands upon thousands of service codes that can be bundled together for claims payment – and avoid improper billing.

No Surprises Act Includes Directory Update Requirement - 02/10/2023

In addition to resolving payment disputes over out-of-network medical care, the federal No Surprises Act aims to make sure health plans’ practitioner directories stay up to date, and part of that aim puts an onus on physicians.

Medicine to Congress: Don’t Give Health Plans More Leverage - 02/09/2023

The federal government should take a balanced approach to surprise medical bills that includes commercially reasonable upfront payments and independent arbitration, the Texas Medical Association and many other medical societies are telling key members of Congress.

TMA Offers Remedies to Ease Surprise Billing - 02/08/2023

Texas patients sometimes feel the pain from unexpected out-of-pocket costs not covered by their health insurance, known as “surprise billing” or “balance billing.” The Texas Medical Association (TMA) is taking aim at the problem, which occurs when a health insurance company pays less than what a doctor charges, leaving the patient to pay the balance of the bill.

Here’s Your Billing and Collections Checklist for 2023 - 01/06/2023

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 2023 to keep your billing and collections on track throughout the year.

OIG: Physicians Incorrectly Billing for End-of-Life Care Planning - 01/05/2023

Advance care planning (ACP) services were meant to give patients the opportunity to choose the care that is right for them at the end of their lives or during medical crises that could render them unable to make personal health decisions.

Check Claims Dates for Drug Administration as Coding Updates Loom - 12/02/2022

With annual updates to billing codes for medications set for Jan. 1, physicians are reminded to use the most current National Drug Code (NDC) and Healthcare Common Procedure Coding System (HCPCS) combinations when filing claims for drug administration.

E/M Revisions in 2023 CPT Code Set Aim to Simplify Documentation - 11/02/2022

In an effort to continue to tamp down physicians’ administrative burden, the American Medical Association has revised the codes and guidelines for most evaluation and management services in its 2023 Current Procedural Terminology code set.

No Penalties for Now in Medicare’s Appropriate Use Criteria Program - 10/25/2022

The Centers for Medicare & Medicaid Services (CMS) has said it would postpone indefinitely the payment penalty phase of its appropriate use criteria (AUC) program, which was expected to begin as soon as Jan. 1, 2023.

Practice E-Tips on Billing and Collections - 10/19/2022

Practice E-Tips on Billing and Collections

Practice e-Tips on Practice Operations - 10/11/2022

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

Practice Operations Services - 09/16/2022

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 - 09/15/2022

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.

Pass-Through Billing Generally Not Permitted - 09/14/2022

Pass-through billing occurs when an ordering physician requests a service and bills insurance for it but does not perform the service. Insurance companies generally forbid this practice.

Don’t Forfeit Your APM Incentive Payment; Act Now - 08/23/2022

Wondering where your 5% payment incentive is for participating in an advanced alternative payment model (APM) in the 2020 Quality Payment Program?

Operations Improvement Plan - 08/03/2022

TMA Practice Consulting is offering up to 20 AMA PRA Category 1 CreditsTM, per physician, when an Operations or Billing/Collections Assessment is performed for their practice.

Nickel and Dimed: Physicians Can Avoid Electronic Credit Cards and Their Fees - 07/29/2022

Some small medical insurance companies are trying to force physicians to receive payment via electronic credit cards, but medical practices can avoid this costly problem.

New FAQ Offers Information on Virtual Credit Card Payments - 07/20/2022

Federal authorities are clarifying the legality of health plans paying claims through virtual credit cards, which typically result in fees for practices.

CMS Continues Webinar Series on No Surprises Act - 07/07/2022

Two upcoming webinars from the Centers for Medicare & Medicaid Services (CMS) – including one scheduled for next week – will educate physicians on the federal No Surprises Act (NSA) as part of a collaboration between CMS and the American Medical Association.

About Nurses as Assistants at Surgery - 06/22/2022

Learn what a first assistant nurse is, and how to bill when they assist during surgery.