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How to Avoid Coding Mistakes in Texas Medicaid - 10/15/2021

Ensuring Texas Medicaid dollars are spent for their intended purpose requires the Texas Health and Human Services (HHS) Office of Inspector General (OIG) to work with health care professionals to prevent waste. Accurate medical coding is part of that work. Incorrect codes result in overpayments – which impact taxpayers – and underpayments, which can impact your practice.


Practice E-Tips on Billing and Collections - 10/12/2021

Practice E-Tips on Billing and Collections


Practice e-Tips on Practice Operations - 10/08/2021

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


When Should We Write Off Large Patient Balances? - 09/23/2021

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


COVID-19: Billing and Coding - 09/16/2021

View COVID-19 resources related to billing and coding.


Starting a Practice - 09/07/2021

Setting Up or Closing a Practice


Billing for Telemedicine During COVID-19 - 09/06/2021

COVID-19 prompted an increased need for telemedicine services to connect physicians with their patients. To quickly meet that need, Texas Medicaid adopted waivers and changed policies to ease technology restrictions and expand the number of Medicaid services available virtually. Reimbursement for telemedicine and telehealth averaged less than $800,000 per month in 2019. By April 2020, Medicaid payment for virtual services jumped to $43 million, and averaged more than $37 million monthly throughout 2020.


Practice e-Tips on Claims - 09/01/2021

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


Practice e-Tips on Reimbursement - 08/28/2021

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


ESRD Calculator - 08/27/2021

ESRD Calculator


Notice to Patients of Noncovered Services - 08/27/2021

Notice to Patients of Noncovered Services


What Triggers a Coding Audit? - 08/20/2021

What Triggers a Coding Audit?


The Finer Points of Professional Courtesy - 08/20/2021

The Finer Points of Professional Courtesy


New CPT Codes for Third Moderna, Pfizer COVID-19 Shots - 08/18/2021

AMA has expedited a new administration code for a potential third dose of Moderna’s COVID-19 vaccine, following release of the CPT code for a third dose of the Pfizer vaccine.


New Patient Visit Not “Incident-to” - 08/17/2021

If a new Medicare patient comes into the office and sees the physician assistant (PA) only, can we bill Medicare for the PA’s services as “incident to” the physician?


Situational Data Element - 08/17/2021

Situational data element


Are You Losing Revenue by Undercoding? - 08/17/2021

Becuase of a fear of overcoding, undercoding is prevalent in many practices. This means lost revenue that is rightfully due to the practice. Correct coding can be a significant opportunity for revenue enhancement without additional resource consumption.


TMA Reimbursement Services - 08/13/2021

TMA Payment Advocacy Services


United Walks Back Payment Cut on Nonphysician Billing - 08/05/2021

Following strong pushback from the Texas Medical Association, UnitedHealthcare (UHC) has effectively reversed its payment-cutting policy change on “incident-to” billing for services performed by nonphysician practitioners (NPPs). 


Arbitration Requests Up, Consumer Complaints Down Under State Surprise Billing Law - 07/29/2021

Texas’ law to prevent patients from getting unanticipated bills for out-of-network care is resulting in more requests for arbitration between practitioners and insurers this year, while consumer complaints are on the decline since the law’s implementation, according to a Texas Department of Insurance report on the impact of the law six months into 2021.


Incident-To Billing Got You Confused? TMA Can Help - 07/12/2021

“Incident-to” billing – when services delivered by a nonphysician practitioner are billed under a supervising physician’s credentials – can be confusing, and Texas Medical Association staff are routinely fielding questions about those unique arrangements.


TMA Case Study: Coding and Documentation - 06/29/2021

TMA’s certified professional coders and auditors can help protect your revenue by performing an in-depth review of how your practice documents medical records and codes claims. The review helps streamline coding and documentation processes, and decrease the risk of external audits.


COVID-19: Payers / Insurance - 06/22/2021

Get COVID-19 resource related to payers / insurance.


First Across the Finish Line: Medical Billing Tax Eliminated - 06/07/2021

More than a year of work and collaboration came to fruition with House Bill 1445 by Rep. Tom Oliverson, MD (R-Cypress), which classifies outsourced medical billing as being outside the realm of insurance services. When Gov. Greg Abbott signed the bill on April 30, it nullified a medical billing tax scheduled to take effect Oct. 1.


UHC Expands Access to Digital Claims Portal, Optum Pay Basic - 05/20/2021

Starting this Saturday, May 22, UnitedHealthcare's Optum Pay basic claims portal will begin allowing unlimited users for each account. Practices can use the portal to manage claim payments and other digital administrative paperwork.