Medicare Compliance & Reimbursement

Stay abreast of changes and secure a healthy bottom line.You want to avoid these three mistakes which could be leading to regular denials -- and chargebacks. While it is comfortable to tread the beaten path, you also need to be certain that it does not lead away from your goal, which is to ethically maximize reimbursement.1. Still Reporting Consults to Part B. If you still submit claims for consultation codes to a Part B payer, you're probably seeing denials every day.Background: Effective January 1, 2010, CMS eliminated payment for the use of all consultation codes (99251-99255, Inpatient consultation for a new or established patient...) and outpatient (99241-99245, Office consultation for a new or established patient ...). Although you may be aware of this fact, it's possible that the codes are still billable in your system, leading many practitioners and coders to mistakenly select them when billing Medicare. Adding to the confusion, [...]