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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?


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.


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?


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?


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


Medicare Cuts An Insult to Patients And Physicians - 11/12/2021

Opinion column by TMA President E. Linda Villarreal, MD, about significant Medicare cuts planned for January, 2022 if Congress does not act to prevent them.


Impending Medicare Pay Cuts Total Nearly 10% - 11/08/2021

Physicians in Medicare are about to get nickel-and-dimed – only it’s more like hundred-and-thousand-ed. And with a pandemic making this moment one of the worst times to financially hit physician practices still reeling from shutdowns last year, the Texas Medical Association, American Medical Association, and others are urging Congress to stop impending payment cuts that could devastate access to care for the nation’s elderly and disabled.


CMS Finalizes Medicare Physician Pay Cut – But Congress Can Still Act - 11/05/2021

Medicare has released its final 2022 physician fee schedule, cementing a series of mandated pay cuts totaling nearly 10% for Medicare-participating physicians, unless Congress votes to reverse them before the end of the year.


Medicare Cuts Would Threaten Patients’ Access to Care - 11/02/2021

Texas Medicare patients could soon struggle to get a physician’s care if planned Medicare payment cuts take place on January 1. According to a new Texas Medical Association (TMA) survey, the nearly 10% Medicare pay cut Congress has scheduled for the new year could devastate physicians who care for the senior citizens and people with disabilities covered by the federal health insurer.


Insurers’ Unfair Electronic Fees Persist; AMA, TMA Take Action - 10/27/2021

Organized medicine, including the Texas Medical Association, is engaging the Biden administration on health plans’ unfair business practices physicians sometimes encounter when receiving electronic payments.


Code Carefully for Bilateral Procedures - 10/27/2021

Coding for bilateral procedures can be confusing. Many payers accept CPT modifier 50 as an indicator of a bilateral procedure, but they differ in how they apply it to their coding and payment policies.


Survey: Medicare Cuts Could Force Physicians to Drop Care Even Amid Pandemic - 10/19/2021

With physicians facing several Medicare payment cuts totaling nearly 10% at the start of 2022, a new Texas Medical Association member survey quantifies the drastic impact the cuts could have on access to care if Congress doesn’t act to stop the cuts.


Medicare Cuts an Insult to Patients and Physicians - 10/13/2021

What would you do if your employer cut your pay by 10% during one of the most stressful times in recent history? And what if your company did that after not giving you a cost-of-living raise for more than two decades?


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

Practice E-Tips on Billing and Collections


Unfreezing GME: A Boost to Federal Funding for Residencies - 10/02/2021

U.S. lawmakers may be ready to boost federal funding for residencies.


Medicare’s Quality Payment Program Won’t Support Internet Explorer 11 - 09/29/2021

Due to security concerns, Medicare’s Quality Payment Program (QPP) will no longer support the Internet Explorer (IE) 11 browser beginning on Oct. 13, the Centers for Medicare & Medicaid Services (CMS) has announced.


Texas ACOs Produce Millions in Medicare Shared Savings Despite Pandemic - 09/09/2021

After a transition year in 2019,  accountable care organizations (ACOs) enrolled in the Medicare Shared Savings Program (MSSP) faced another daunting challenge: the COVID-19 pandemic.


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

Get practice tips on all things Medicare. Learn what Medicare requires for enrollment, participation, billing, claims, coding, documentation, and more.


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


How Do I Get Started With CCM Services? - 08/19/2021

CCM services are non-face-to-face activities performed by you or your clinical staff to manage and coordinate the care of your patients. To initiate the services, Medicare requires that you first obtain a patient’s informed and written consent* during a face-to-face visit, such as during an initial preventive physician exam, annual wellness visit, or comprehensive evaluation and management visit billed separately.


Feds Declare “Long COVID” a Disability - 08/17/2021

Although the pandemic rages on, there may be some relief in sight for people with lingering effects from COVID 19 infection – or “long COVID” – as well as consequences for the physicians who treat and employ them. The Biden administration in late