Medicare Compliance & Reimbursement

Check your own methods against these coding and billing pitfalls. If you subscribe to any of these common medical practice billing and coding myths, you could be harming your practice's bottom line. Get to know the facts and you'll recoup your pay every time. Myth #1: You have to bill everyone the same amount. Fact: "Practices cannot bill Medicare patients higher than other payers," says Suzan Berman-Hvizdash, CPC, CEMC, CEDC, senior manager of coding and compliance with the UPMC departments of surgery and anesthesiology in Pittsburgh. "However, if they have a contractual agreement with another payer to charge that payer more, they can do so," she says. Practices often maintain several fee schedules that correspond to different insurers. "The most important piece is the reimbursement," Berman-Hvizdash says. "The contracts with the various payers are going to dictate the reimbursement. This could vary greatly from payer to payer, state to state, [...]