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Aetna Set to Pay Medicare Advantage G2211 Claims - 03/27/2024

The list of health plans providing payment for Medicare’s new add-on “G” code continues to grow with Aetna as the latest insurer to cover G2211 for Medicare Advantage claims Aetna confirmed with Texas Medical Association coding experts that its Medicare Advantage claims platform was updated in March to allow payment for the code, used to document the coordination of care for patients with complex or serious conditions. For now, the plan’s policy is only accessible through a physician’s Aetna portal.

Quality of Life: Pay-for-Quality Programs Increasingly Address Nonmedical Drivers of Health - 03/15/2024

Insurance payers seldom give physicians incentives to address nonmedical drivers of health, especially in traditional fee-for-service payer contracts. Those incentives remain rare even in pay-for-quality programs that emphasize value-based care, but they are gaining traction.

Coding Changes in Fee Schedule Promote More Accurate Payment for Complex Visits - 03/05/2024

The 2024 Medicare physician fee schedule allows physicians to list G2211 in addition to codes used in office or outpatient visits for new or established patients (i.e., 99202-99215). Physicians also can use it for telehealth visits.

Novitas Makes Mass Payment Adjustment for Telehealth Claims - 02/27/2024

Thanks to the vigilance of the Texas Medical Association’s payment specialists, Medicare administrative contractor Novitas Solutions updated its system to ensure all claims billed with place of service (POS) code 10 will be paid correctly.

Practice e-Tips on Coding - 02/20/2024

Get practice tips on all things coding. Learn about coding methods, correct coding, resources, coding related to Workers' Comp and more.

Staff Recruitment - 01/22/2024

Personalized recruiting of qualified staff for front office, billing, clinical, and management positions. We provide assistance with job descriptions, résumé review and evaluation, reference and background checks, on-site interviews and training.

Revenue Cycle Assessment Training - 01/22/2024

A TMA consultant will provide training to assist the practice in developing policies and procedures for effective billing and collections processes.

Revenue Cycle Assessment - 01/22/2024

A TMA consultant will conduct a review of your business office operations that focuses on front desk procedures, billing, collections and revenue cycle improvement. We will identify opportunities for improvement of billing processes and procedures.

On-site Training - 01/22/2024

This service for physicians and staff is customized for your practice’s specific needs. Discover what these hands-on training sessions cover.

Human Resources Services - 01/22/2024

While having sound and consistent hiring practices will help your practice attract candidates, keeping them takes a lot more effort. A TMA practice management consultant can assist with human resource challenges.

Financial Management Services - 01/22/2024

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.

Embezzlement Risk Review - 01/22/2024

Medical practices are especially vulnerable to embezzlement because they are typically cash businesses run by a close-knit staff that the physician tends to regard as “family.” You can protect your practice by establishing a formalized system of controls for monitoring money.

Custom Services - 01/22/2024

In today’s complex health care environment, no two practices are exactly alike. Let TMA Practice Consulting customize an innovative solution for you.

Your Billing and Collections Checklist for 2024 - 12/19/2023

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 2024 to keep your billing and collections on track throughout the year.

Add-On Payment Code for Complex Visits to Start in 2024 - 12/08/2023

Beginning in January, physicians will be able to receive more accurate payment for complex visits with Medicare add-on code G2211. But the Texas Medical Association continues to push for additional guidance as confusion over the code’s use persists.

CMS to Implement Street Medicine Code - 10/25/2023

Following advocacy from the Texas Medical Association and medical student members, the Centers for Medicare & Medicaid Services (CMS) created a place of service code for street medicine, making it possible for physicians to get paid for services provided to people who are currently unhoused effective Oct. 1.

Code Carefully for Bilateral Procedures - 10/04/2023

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.

Checklist for Closing or Selling a Practice - 08/30/2023

Checklist for Closing or Selling a Practice

Three Steps to a Tech Contract You Can Live With - 08/30/2023

When you are shopping for a new technology vendor for your practice, signing a contract is the easy part. The real work starts well in advance and continues as long as the contract is in force.

Billing Errors to Avoid: Pulmonary, Mohs Procedures - 08/21/2023

Medicare audits have revealed recurring errors in billing for pulmonary procedures and Mohs surgery. Here are some guidelines for correct billing.

Medicare Coding Errors to Avoid: Add-on, Place of Service, and Modifiers - 08/21/2023

Medicare audits have revealed recurring errors in billing with add-on and place-of-service codes as well as claims that appear to be duplicate because they lack an appropriate modifier. Here are some guidelines for correct billing.

Use Modifiers to Override Correct Coding Initiative Edits - 08/21/2023

Correct Coding Initiative Edits Now Free on Internet

More Medicare Payment Updates for 2015 - 08/21/2023

Find out changes affecting pneumococcal vaccine, preventive and screening services, and new waived tests, plus a revalidation tip and how to learn more about Physician Compare.

Payers Axe Consultation Codes - 07/25/2023

Both Cigna and UnitedHealthcare (UHC) have announced that starting in October, they will no longer pay for CPT consultation codes 99241-99245 – office consultations – and 99251-99255 – inpatient consultations. UHC’s policy change becomes effective Oct. 1, as outlined in its March bulletin. Cigna’s July newsletter says Cigna’s policy takes effect Oct. 19.

E&M Coding — Are You Under, Over, or on Target? - 07/20/2023

E&M Coding — Are You Under,Over,or on Target?