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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.


Practice E-Tips on Billing and Collections - 02/20/2024

Practice E-Tips on Billing and Collections


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.


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. 


Here’s Everything You Need to Spread the Word About Flu Vaccines - 09/06/2023

Today is Texas Influenza Awareness Day, which the Texas Department of State Health Services designated to stress the importance of every Texan over 6 months old receiving a seasonal flu vaccine. The Texas Medical Association’s Be Wise – Immunize program has created several tools and resources you can use to get the word out today and throughout flu season.


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.


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.


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?


5010 Deadline Extended; Dual Eligible Problem Not Fixed - 07/25/2023

Acknowledging that many physicians and billing entities still aren't ready, federal officials are giving physicians three more months before it begins enforcing the use of Health Insurance Portability and Accountability (HIPAA) 5010 transaction standards. The new deadline is June 30.


What Stimulus Means to Texas Health Care - 07/25/2023

State health officials have released preliminary information on major health and human services allocations for Texas in the $789 billion economic stimulus bill President Obama signed. The largest portion is $5.45 billion for Medicaid through the first quarter of 2011.


Practice e-Tips on Claims - 07/20/2023

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 - 07/20/2023

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


You Can Get Paid for Medicaid Emergency Services - 07/20/2023

You Can Get Paid for Medicaid Emergency Services


Doctors Say Vaccinations Key to Preventing a Deadly Flu Season - 06/28/2023

Look out: Here comes flu season. Even though the flu is an annual occurrence, the Centers for Disease Control and Prevention (CDC) branded the 2017-18 flu season as one of the worst in recent years.


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.


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.


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.


Flu, RSV Outbreaks Worsen as “Tripledemic” Threatens - 12/02/2022

Texas Medicine Today recently reported that influenza, respiratory syncytial virus, and other respiratory ailments are poised to overwhelm hospitals and clinics. The big question then was, would this problem get worse?


Take 15 Seconds to Encourage Flu Vaccinations - 11/11/2022

What if 15 seconds was all it took to educate and encourage your patients about getting their flu shots? TMA has added two new 15-second videos to its Vaccines Defend What Matters (VDWM) resources to help.


Upcoming Flu Season, Vaccine Hesitancy Could Intensify as Side Effects of Pandemic - 09/27/2022

The COVID-19 pandemic has shaped recent flu seasons, and there’s reason to believe this trend will continue.


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.


Expect a More Serious Flu Season – and Test Accordingly, DSHS Says - 04/05/2022

In 2021, precautions that people took against COVID-19 – like masking and social distancing – helped create an unusually light flu season, says Jennifer Shuford, MD, chief state epidemiologist at the Texas Department of State Health Services (DSHS). In 2022, Texas probably will not be as lucky.


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.