Practice Management Alert
Improve Your A/R by Collecting Surgical Deductibles Up Front
Find out early on if the patient won't be able to pay your practice. With fewer patients ... Read more
Find out early on if the patient won't be able to pay your practice. With fewer patients ... Read more
You Be the Billing Expert:
Who Do You Bill When You're a Non-Par Provider?
Question: I have found it virtually impossible to find out the allowable when your provid... Read more
Who Do You Bill When You're a Non-Par Provider?
Question: I have found it virtually impossible to find out the allowable when your provid... Read more
News You Can Use:
CMS Scraps Consults, Cuts Pay by 21.2%
Bonus: CMS increases pay for office visit codes. Every year, practices wait for the Medic... Read more
CMS Scraps Consults, Cuts Pay by 21.2%
Bonus: CMS increases pay for office visit codes. Every year, practices wait for the Medic... Read more
Coding Corner:
Learn CCI Basics -- Or Watch Denials Flood In
Not overriding when you can means missing billable services. When a payer blames claim de... Read more
Learn CCI Basics -- Or Watch Denials Flood In
Not overriding when you can means missing billable services. When a payer blames claim de... Read more
Payer Updates:
Senate Probe Uncovers Major Underspending by Several Payers
Plus, Georgia insurance commissioner slaps UHG with hefty fines for payment delays. A U.S... Read more
Senate Probe Uncovers Major Underspending by Several Payers
Plus, Georgia insurance commissioner slaps UHG with hefty fines for payment delays. A U.S... Read more
READER QUESTIONS :
Count Supply Cost in In-Office Procedure Pay
Question: My doctors want me to bill for supplies, such as surgical trays, that they use ... Read more
Count Supply Cost in In-Office Procedure Pay
Question: My doctors want me to bill for supplies, such as surgical trays, that they use ... Read more
READER QUESTIONS :
You Can Skip Modifier 51 for Some Carriers
Question: I previously often used modifier 51. Now,I'm unsure when it is required. Do som... Read more
You Can Skip Modifier 51 for Some Carriers
Question: I previously often used modifier 51. Now,I'm unsure when it is required. Do som... Read more
READER QUESTIONS :
You Have a Reprieve -- Red Flags Rule Delayed
Question: I thought the Red Flags Rule was due to go into effect this month. I haven't he... Read more
You Have a Reprieve -- Red Flags Rule Delayed
Question: I thought the Red Flags Rule was due to go into effect this month. I haven't he... Read more
READER QUESTIONS :
Avoid Billing for Government-Provided H1N1 Drug
Question: Our practice is planning to offer H1N1 vaccinations. How should we bill for the... Read more
Avoid Billing for Government-Provided H1N1 Drug
Question: Our practice is planning to offer H1N1 vaccinations. How should we bill for the... Read more
Avoid On-Call Fraud Accusations With This Billing FAQ
Beware: You can't capture ER coverage services with after-hours codes. If you bill incorr... Read more
Beware: You can't capture ER coverage services with after-hours codes. If you bill incorr... Read more
You Be the Billing Expert:
Does Timely Filing Miss Always Mean No Pay?
Question: A payer denied our claim because we missed the timely filing deadline. The prob... Read more
Does Timely Filing Miss Always Mean No Pay?
Question: A payer denied our claim because we missed the timely filing deadline. The prob... Read more
Lower Overhead, Improve Care With House Calls
Weigh the benefits of offering in-home visits to your patients. If your practice is looki... Read more
Weigh the benefits of offering in-home visits to your patients. If your practice is looki... Read more
Considering House Calls? Get the Scoop on Billing
If you can't prove medical necessity, skip 99341-99345. Watch out: If your physician is t... Read more
If you can't prove medical necessity, skip 99341-99345. Watch out: If your physician is t... Read more
Payer Updates:
Check Your Payers Against the AMA's 2009 Report Cards
See which payers rank highest in 6 billing categories. Are you curious about where your t... Read more
Check Your Payers Against the AMA's 2009 Report Cards
See which payers rank highest in 6 billing categories. Are you curious about where your t... Read more
READER QUESTIONS:
Overcome Complicated Complication Differences
Question: A patient who is in the 90-day global period of a surgical procedure has compli... Read more
Overcome Complicated Complication Differences
Question: A patient who is in the 90-day global period of a surgical procedure has compli... Read more
READER QUESTIONS:
Your E/M Doesn't Have to Match the Hospital's E/M
Question: My physician removed a catheter in an outpatient hospital exam room. Should I i... Read more
Your E/M Doesn't Have to Match the Hospital's E/M
Question: My physician removed a catheter in an outpatient hospital exam room. Should I i... Read more
READER QUESTIONS:
Avoid Double-Billing Radiology Procedures
Question: A patient suffered a blow to the head and displayed symptoms of dizziness, slee... Read more
Avoid Double-Billing Radiology Procedures
Question: A patient suffered a blow to the head and displayed symptoms of dizziness, slee... Read more
READER QUESTIONS:
What Product Code for Swine Flu Vaccine?
Question: I bill for a pediatrician. Some patients' parents are requesting that their chi... Read more
What Product Code for Swine Flu Vaccine?
Question: I bill for a pediatrician. Some patients' parents are requesting that their chi... Read more
READER QUESTIONS:
Your Practice Doesn't Get to Set Co-Pays
Question: We are having an issue in our office regarding 56441. The patient had a vaginal... Read more
Your Practice Doesn't Get to Set Co-Pays
Question: We are having an issue in our office regarding 56441. The patient had a vaginal... Read more
Step Up Your Collection Efforts With Credit Card Acceptance
Caveat: Protect your patients' credit information to comply with privacy, identity theft ... Read more
Caveat: Protect your patients' credit information to comply with privacy, identity theft ... Read more
You Be the Billing Expert:
Do You Bill the Payer After Benefits Run Out?
Question: A patient who is receiving mental health services has used up all his benefits.... Read more
Do You Bill the Payer After Benefits Run Out?
Question: A patient who is receiving mental health services has used up all his benefits.... Read more
News You Can Use:
Learn 2 New CMS Appeal Thresholds Before Filing
CMS changes amounts -- here are the details you need to know. The time has come yet ... Read more
Learn 2 New CMS Appeal Thresholds Before Filing
CMS changes amounts -- here are the details you need to know. The time has come yet ... Read more
Coding Corner:
3 Tips Eliminate 'Admit' Coding Confusion
CMS changes amounts -- here are the details you need to know. The time has come yet ... Read more
3 Tips Eliminate 'Admit' Coding Confusion
CMS changes amounts -- here are the details you need to know. The time has come yet ... Read more
Payer Updates:
Aetna Announces New Policy of Payment Refusal for 'Never Events'
Make sure you know the extra steps you need to take as well. Many payers are jumping on t... Read more
Aetna Announces New Policy of Payment Refusal for 'Never Events'
Make sure you know the extra steps you need to take as well. Many payers are jumping on t... Read more
READER QUESTIONS:
Expect Payment for H1N1 Administration
Question: Our practice is preparing to administer the H1N1 vaccine. How will we bill Medi... Read more
Expect Payment for H1N1 Administration
Question: Our practice is preparing to administer the H1N1 vaccine. How will we bill Medi... Read more
READER QUESTIONS:
Learn the Fee Schedule Column Differences
Question: I hear all the time that I should be looking at the Medicare Physician fee sche... Read more
Learn the Fee Schedule Column Differences
Question: I hear all the time that I should be looking at the Medicare Physician fee sche... Read more
READER QUESTIONS:
Don't Write Off Non-Par Medicaid Bills
Question: I was told that if a patient has Medicaid (which we do not participate in) we c... Read more
Don't Write Off Non-Par Medicaid Bills
Question: I was told that if a patient has Medicaid (which we do not participate in) we c... Read more
READER QUESTIONS:
Payer Preference Determines G0027 Vs. 89321
Question: Code G0027 is listed as a provider performed microscopic procedure to test for ... Read more
Payer Preference Determines G0027 Vs. 89321
Question: Code G0027 is listed as a provider performed microscopic procedure to test for ... Read more
READER QUESTIONS:
You Can Append 25 to Critical Care
Question: My surgeon performed critical care services and laceration repairs on the same ... Read more
You Can Append 25 to Critical Care
Question: My surgeon performed critical care services and laceration repairs on the same ... Read more
Seek Outside Help For Lingering Payer, Claims Issues
When a problem payer won't communicate, lean on your colleagues for support. What if you ... Read more
When a problem payer won't communicate, lean on your colleagues for support. What if you ... Read more
You Be the Billing Expert:
Can You Incident-to Bill Under the Medical Director?
Question: Is there any circumstance in which a group can bill all services and all provid... Read more
Can You Incident-to Bill Under the Medical Director?
Question: Is there any circumstance in which a group can bill all services and all provid... Read more
Quick Quiz Answers:
Find Out Where You Need to Hone Your Collections Skills
Check your answers from last month's collections quiz. You know that solid collections kn... Read more
Find Out Where You Need to Hone Your Collections Skills
Check your answers from last month's collections quiz. You know that solid collections kn... Read more
News You Can Use:
No-Pay Consult Proposal Could Hit Practices Hard
Your revenue might go down, but your compliance will be up. If your practice relies on co... Read more
No-Pay Consult Proposal Could Hit Practices Hard
Your revenue might go down, but your compliance will be up. If your practice relies on co... Read more
Payer Updates:
Watch the Mail If You're Part of the BCBS Settlement
Plus, Aetna, UHC launch WhiteGlove House Call service in Texas. If your physician was pa... Read more
Watch the Mail If You're Part of the BCBS Settlement
Plus, Aetna, UHC launch WhiteGlove House Call service in Texas. If your physician was pa... Read more
In other news:
In other news:
WhiteGlove is a company that allows its customers and their families to schedule medical v... Read more
In other news:
WhiteGlove is a company that allows its customers and their families to schedule medical v... Read more
READER QUESTIONS:
Do Your Homework Before Hiring Outside Help
Question: Our practice just combined with another practice, and we're thinking about outs... Read more
Do Your Homework Before Hiring Outside Help
Question: Our practice just combined with another practice, and we're thinking about outs... Read more
READER QUESTIONS:
Let Payers Reduce Your Multiple Procedure Fees
Question: Are insurance companies allowed to reduce our fees for multiple procedures perf... Read more
Let Payers Reduce Your Multiple Procedure Fees
Question: Are insurance companies allowed to reduce our fees for multiple procedures perf... Read more
READER QUESTIONS:
Having a Physician Sign All Notes Is Good Practice
Question: The Pennsylvania Medical Society states that if a PA prescribes medications, th... Read more
Having a Physician Sign All Notes Is Good Practice
Question: The Pennsylvania Medical Society states that if a PA prescribes medications, th... Read more
READER QUESTIONS:
Don't Waste Time Billing $0 Charges
Question: I bill post-op visits with CPT code 99024 and charge $0. Sometimes it goes thro... Read more
Don't Waste Time Billing $0 Charges
Question: I bill post-op visits with CPT code 99024 and charge $0. Sometimes it goes thro... Read more
READER QUESTIONS:
Maximize Billing for Oxygen Therapy in the Office
Question: Can we bill for oxygen therapy given to patients in the office during an E/M se... Read more
Maximize Billing for Oxygen Therapy in the Office
Question: Can we bill for oxygen therapy given to patients in the office during an E/M se... Read more
Master the Art of Working With -- Or Around -- Problem Payers
Follow this 3-step path and get results from every payer. At some point in her career, ev... Read more
Follow this 3-step path and get results from every payer. At some point in her career, ev... Read more
You Be the Billing Expert:
Electronic Vs. Paper Record Retention
Question: My practice is running out of space for storing our paper records. How long do w... Read more
Electronic Vs. Paper Record Retention
Question: My practice is running out of space for storing our paper records. How long do w... Read more
Coding Corner:
Begin Prep for ICD-10 and HIPAA Form Changes
Tip: Make sure your software vendor is preparing, too. Changes are on the horizon, and al... Read more
Begin Prep for ICD-10 and HIPAA Form Changes
Tip: Make sure your software vendor is preparing, too. Changes are on the horizon, and al... Read more
Quick Quiz:
Test Your Collections Skills With 5 Questions
Know what your options are for non-par patients. You know that solid collections knowledg... Read more
Test Your Collections Skills With 5 Questions
Know what your options are for non-par patients. You know that solid collections knowledg... Read more
Payer Updates:
BCBS Recovered $350 Million in 2008 Anti-Fraud Efforts
Plus, Medicare strike force hands out justice in Motown. The Blue Cross and Blue Shield A... Read more
BCBS Recovered $350 Million in 2008 Anti-Fraud Efforts
Plus, Medicare strike force hands out justice in Motown. The Blue Cross and Blue Shield A... Read more
Reader Question:
Geography Affects Your Payments
Question: My physician has asked me to explain how to figure out what our reimbursement w... Read more
Geography Affects Your Payments
Question: My physician has asked me to explain how to figure out what our reimbursement w... Read more
Reader Question:
NGS Plans to Retract Lesion Coding LCD
Question: Our practice is very confused about a recent LCD from NGS about how they want u... Read more
NGS Plans to Retract Lesion Coding LCD
Question: Our practice is very confused about a recent LCD from NGS about how they want u... Read more
Consider Patient Payment Plans Rather Than Collection Agencies
Avoiding aggressive collections efforts can save patient relations and money. If your pro... Read more
Avoiding aggressive collections efforts can save patient relations and money. If your pro... Read more
You Be the Billing Expert :
Medicaid Secondary Balances
Question: A patient has a Medicare replacement plan and then has Medicaid as secondary in... Read more
Medicaid Secondary Balances
Question: A patient has a Medicare replacement plan and then has Medicaid as secondary in... Read more
Employ Promissory Notes and Payment Agreements
Using a standard form can help you set up patient payment plans. When you're setting up p... Read more
Using a standard form can help you set up patient payment plans. When you're setting up p... Read more
Coding Corner:
Capitalize on Physician's After Hours Services
Show your payer the cost of not paying on after-hours codes. If your practice is open dur... Read more
Capitalize on Physician's After Hours Services
Show your payer the cost of not paying on after-hours codes. If your practice is open dur... Read more
Payer Updates:
Indiana Joins Ohio in Requesting Anthem Payment Investigations
Plus, Humana ranks as fastest payer. In May the Indiana State Medical Association filed a... Read more
Indiana Joins Ohio in Requesting Anthem Payment Investigations
Plus, Humana ranks as fastest payer. In May the Indiana State Medical Association filed a... Read more
READER QUESTIONS :
Prevent Co-Surgery Denials With Modifier Help
Question: Our physicians often work with other surgeons in the operating room. We seem to... Read more
Prevent Co-Surgery Denials With Modifier Help
Question: Our physicians often work with other surgeons in the operating room. We seem to... Read more
Reader Question:
Turn Over Records Even If Patient Owes You
Question: We have a patient with a large balance. She recently called our office and aske... Read more
Turn Over Records Even If Patient Owes You
Question: We have a patient with a large balance. She recently called our office and aske... Read more
Reader Question:
Don't Just Cover Up Paper Claim Errors
Question: When we have to submit a paper claim and we make a mistake on the form, can we ... Read more
Don't Just Cover Up Paper Claim Errors
Question: When we have to submit a paper claim and we make a mistake on the form, can we ... Read more
Better Collections Rates Start With Better Collections Skills
Well-trained billers may be your biggest assets toward improved collections. ... Read more
Well-trained billers may be your biggest assets toward improved collections. ... Read more
You Be the Billing Expert:
Recouping Missed Payments
Question: Ive landed a job with a private practice where no one seems to follo... Read more
Recouping Missed Payments
Question: Ive landed a job with a private practice where no one seems to follo... Read more
News You Can Use:
Breathe Easier Thanks to the Red Flags Rule Delay
Youll have more time to get your practice in shape. If youre still ... Read more
Breathe Easier Thanks to the Red Flags Rule Delay
Youll have more time to get your practice in shape. If youre still ... Read more
Sample collections role-play scenario
Use two volunteers. Have one play the collector and one play the patient. The ... Read more
Use two volunteers. Have one play the collector and one play the patient. The ... Read more
READER QUESTIONS:
PQRI Participation Doesn't Have to Be Hard
Question: Reporting on PQRI measures seems complicated. Im not sure my office has the ti... Read more
PQRI Participation Doesn't Have to Be Hard
Question: Reporting on PQRI measures seems complicated. Im not sure my office has the ti... Read more
Payer Updates:
Cigna Reduces Your 25 and 59 Documentation Requirements
Plus, Cigna launches cost estimator software. Effective April 27, C... Read more
Cigna Reduces Your 25 and 59 Documentation Requirements
Plus, Cigna launches cost estimator software. Effective April 27, C... Read more
In other news:
In other news:
In April Cigna launched a cost of care estimator. This tool is designed to help ... Read more
In other news:
In April Cigna launched a cost of care estimator. This tool is designed to help ... Read more
READER QUESTIONS:
Beware of Payer Tactics During Contract Negotiation
Question: Im trying to negotiate a new fee schedule with a payer. This payer w... Read more
Beware of Payer Tactics During Contract Negotiation
Question: Im trying to negotiate a new fee schedule with a payer. This payer w... Read more
READER QUESTIONS:
Reserve IPPE Billing for First 12 Months
Question: A Medicare patient came to our office for his IPPE exam. However, he... Read more
Reserve IPPE Billing for First 12 Months
Question: A Medicare patient came to our office for his IPPE exam. However, he... Read more
READER QUESTIONS:
Employ Modifier 55 for Post-Op-Only Care
Question: Because we are in a small, rural town, our physician sends many pati... Read more
Employ Modifier 55 for Post-Op-Only Care
Question: Because we are in a small, rural town, our physician sends many pati... Read more
READER QUESTIONS:
Tap Into E-Prescribe 2 Percent Bonus Basics
Question: I heard that physicians may receive bonuses for e-prescribing. What ... Read more
Tap Into E-Prescribe 2 Percent Bonus Basics
Question: I heard that physicians may receive bonuses for e-prescribing. What ... Read more
Stop Letting No-Shows Drain Your Practice Reimbursement
One key is knowing which of your payers let you charge no-show fees. ... Read more
One key is knowing which of your payers let you charge no-show fees. ... Read more
You Be the Billing Experrt:
Medicare as Secondary Payer
Question: Getting Medicare to pay when it is the secondary payer is difficult.... Read more
Medicare as Secondary Payer
Question: Getting Medicare to pay when it is the secondary payer is difficult.... Read more
Clip and Save:
Hold Patients Accountable for Missed Visits With These Tools
Use a series of letters to explain the consequences of missed appointments. ... Read more
Hold Patients Accountable for Missed Visits With These Tools
Use a series of letters to explain the consequences of missed appointments. ... Read more
Quick Quiz Answers:
Suffering From Incorrect E/M Billing? Check Here
Hone your E/M skills with the answers to last months quiz. Evaluati... Read more
Suffering From Incorrect E/M Billing? Check Here
Hone your E/M skills with the answers to last months quiz. Evaluati... Read more
Payer Updates:
CMS Revises PECOS Enrollment Stance -- But Not Officially
Dont breathe a sigh of relief just yet,experts caution. If youve be... Read more
CMS Revises PECOS Enrollment Stance -- But Not Officially
Dont breathe a sigh of relief just yet,experts caution. If youve be... Read more
READER QUESTIONS:
Don't Let Medicare Set Your Fees
Question: I have a procedure code that one insurance allows $185.00, yet Medic... Read more
Don't Let Medicare Set Your Fees
Question: I have a procedure code that one insurance allows $185.00, yet Medic... Read more
READER QUESTIONS:
Face-to-Face Matters When Billing on Time
Question: My physician met with an elderly patients family to discuss treatmen... Read more
Face-to-Face Matters When Billing on Time
Question: My physician met with an elderly patients family to discuss treatmen... Read more
Think the Red Flags Rule Doesn't Affect You? Think Again
Get to know the new identity theft rules that many practices are overlooking. Your practi... Read more
Get to know the new identity theft rules that many practices are overlooking. Your practi... Read more
You Be the Billing Expert:
Incident-To Supervision Requirements
Question: A patient came in to see one of the physicians in our practice. The doctor devel... Read more
Incident-To Supervision Requirements
Question: A patient came in to see one of the physicians in our practice. The doctor devel... Read more
What is the difference between HIPAA and Red Flag?
HIPAA: HIPAA privacy regulations are for protecting a patient's private data or personal h... Read more
HIPAA: HIPAA privacy regulations are for protecting a patient's private data or personal h... Read more
Coding Corner:
Suffering From Incorrect E/M Billing? Find Out Fast
Evaluation and management services represent the bulk of what most practices bill these da... Read more
Suffering From Incorrect E/M Billing? Find Out Fast
Evaluation and management services represent the bulk of what most practices bill these da... Read more
Clip and Save:
Set Up Your Red Flags Plan With These 6 Tips
Ensure your practice is ready by May 1 with a top-notch plan. You-ve got less than two mo... Read more
Set Up Your Red Flags Plan With These 6 Tips
Ensure your practice is ready by May 1 with a top-notch plan. You-ve got less than two mo... Read more
Still Using the Old ABN, NEMB Forms? Stop Now
The drop-dead date for using the updated advance beneficiary notice (ABN) just passed, so ... Read more
The drop-dead date for using the updated advance beneficiary notice (ABN) just passed, so ... Read more
You Be the Billing Expert :
Incident-To Supervision Requirements
Answer: No, you cannot bill this service as incident-to the physician or the physician ass... Read more
Incident-To Supervision Requirements
Answer: No, you cannot bill this service as incident-to the physician or the physician ass... Read more
Payer Updates:
AG Cuomo Hits Aetna, Excellus in Continuing Investigations
New York Attorney General Andrew Cuomo continues his year-long investigation of the insura... Read more
AG Cuomo Hits Aetna, Excellus in Continuing Investigations
New York Attorney General Andrew Cuomo continues his year-long investigation of the insura... Read more
Reader Questions :
Follow Payer Preferences for Destruction Billing
Question: My physician removed 14 premalignant lesions from a patient's face, neck, and sc... Read more
Follow Payer Preferences for Destruction Billing
Question: My physician removed 14 premalignant lesions from a patient's face, neck, and sc... Read more
Reader Questions :
EMTALA Only Applies in the ER
Question: A patient comes to our office, presenting with inner ear pain and dizziness. He ... Read more
EMTALA Only Applies in the ER
Question: A patient comes to our office, presenting with inner ear pain and dizziness. He ... Read more
Reader Questions :
Always Bill the Most Appropriate Code
Question: We keep getting denials on certain codes from certain payers. My physician says ... Read more
Always Bill the Most Appropriate Code
Question: We keep getting denials on certain codes from certain payers. My physician says ... Read more
PECOS Has a 'Flaw' That May Prove Fatal to Your Practice
If you work in the system on your doc's behalf,you-re putting his Medicare credentials a... Read more
If you work in the system on your doc's behalf,you-re putting his Medicare credentials a... Read more
Get the Facts on CMS' 30-Day Retro Billing Rule
You won't forfeit quite as much money as previously expected. While CMS has cut the per... Read more
You won't forfeit quite as much money as previously expected. While CMS has cut the per... Read more
Don't Be Left Empty- Handed -- Bill the Patient
You don't necessarily have to forgo payment due to denial. When you put a claim through... Read more
You don't necessarily have to forgo payment due to denial. When you put a claim through... Read more
Missing Incident-To Signs Could Cost You 15 Percent
Knowing the rules determines 100 percent vs. 85 percent pay. In the office setting, inc... Read more
Knowing the rules determines 100 percent vs. 85 percent pay. In the office setting, inc... Read more
You Be the Billing Expert:
Interpreter Services Billing Varies by Payer
Question: My question is regarding a patient of ours who is deaf. She came to us for an ... Read more
Interpreter Services Billing Varies by Payer
Question: My question is regarding a patient of ours who is deaf. She came to us for an ... Read more
Payer Updates:
BCBS Settlement Provisions Are Now in Effect
Get to know the settlement details. If you bill to Blue Cross Blue Shield, take note. T... Read more
BCBS Settlement Provisions Are Now in Effect
Get to know the settlement details. If you bill to Blue Cross Blue Shield, take note. T... Read more
READER QUESTIONS:
Identify the Request Before Billing a Consult
Question: If our doctor does surgery on a patient who is an inpatient, shouldn't we be c... Read more
Identify the Request Before Billing a Consult
Question: If our doctor does surgery on a patient who is an inpatient, shouldn't we be c... Read more
READER QUESTIONS:
Check Documentation for Malfunction Specifics
Question: I would like to know the correct coding for malfunctioning of a Porta catheter... Read more
Check Documentation for Malfunction Specifics
Question: I would like to know the correct coding for malfunctioning of a Porta catheter... Read more
Perfect Your Non-Par Collections With 4 Options
Prevent hundreds of dollars from running out the door with these expert tips. There are... Read more
Prevent hundreds of dollars from running out the door with these expert tips. There are... Read more
You Be the Billing Expert:
Denials Based on Old CPT Codes
Question: Our practice is having trouble billing the new codes for 2009, in particular C... Read more
Denials Based on Old CPT Codes
Question: Our practice is having trouble billing the new codes for 2009, in particular C... Read more
Coding Corner:
Proactively Avoid Denials By Knowing the CCI Edits
Knowing when you can append a modifier is your key to success The start of a new year m... Read more
Proactively Avoid Denials By Knowing the CCI Edits
Knowing when you can append a modifier is your key to success The start of a new year m... Read more
Learn When You Can Override CCI Edits
Get reimbursement for bundled codes in 3 simple steps. There are times when you can ove... Read more
Get reimbursement for bundled codes in 3 simple steps. There are times when you can ove... Read more
Payer Updates:
Prepare for Restaurant-Style Ratings By BCBS
Plus, Anthem introduces price conscious plan. As part of a continued push by payers and... Read more
Prepare for Restaurant-Style Ratings By BCBS
Plus, Anthem introduces price conscious plan. As part of a continued push by payers and... Read more
In other news:
In other news:
Get ready to learn the ins and outs of yet another medical plan if you bill in Nevada. O... Read more
In other news:
Get ready to learn the ins and outs of yet another medical plan if you bill in Nevada. O... Read more
Reader Questions:
Don't Count on Pay Just Because There's a Code
Question: A new patient came to our office, and the physician did a complete workup, res... Read more
Don't Count on Pay Just Because There's a Code
Question: A new patient came to our office, and the physician did a complete workup, res... Read more
Reader Questions:
Securing CLIA Waivers Could Mean More Pay
Question: During a practice meeting last week, the subject of Clinical Laboratory Improv... Read more
Securing CLIA Waivers Could Mean More Pay
Question: During a practice meeting last week, the subject of Clinical Laboratory Improv... Read more
Reader Questions:
Base Total RVU Calculations on 3 Details
Question: How do I determine which RVUs to use in the Medicare fee schedule for reimburs... Read more
Base Total RVU Calculations on 3 Details
Question: How do I determine which RVUs to use in the Medicare fee schedule for reimburs... Read more
Fight Back Against Lost Pay on High-Cost Procedures
One payer offers you a new tool that may help you collect from patients. Rising costs a... Read more
One payer offers you a new tool that may help you collect from patients. Rising costs a... Read more
You Be the Billing Expert:
Paper vs. Electronic -- The Claims Submission Debate
Question: Does Medicare accept paper claims anymore? I-ve heard that all claims have to ... Read more
Paper vs. Electronic -- The Claims Submission Debate
Question: Does Medicare accept paper claims anymore? I-ve heard that all claims have to ... Read more
New Credentialing Reg Will Cost You 2 Years' Pay
Starting Jan. 1, you can't retroactively bill back 27 months Billing for a new provider... Read more
Starting Jan. 1, you can't retroactively bill back 27 months Billing for a new provider... Read more
Save Hundreds With These A/R Best Practices
Tip: Assign each biller a list of payers to contact every month. You know that every pe... Read more
Tip: Assign each biller a list of payers to contact every month. You know that every pe... Read more
Payer Updates:
Prepare for Increasing Number of Healthcare Credit Cards
Plus, billers in New York should watch out for errors on Part B claims. Credit cards sp... Read more
Prepare for Increasing Number of Healthcare Credit Cards
Plus, billers in New York should watch out for errors on Part B claims. Credit cards sp... Read more
In other news:
In other news:
If you-ve received a few inexplicable denials from your payer, the problem might be due ... Read more
In other news:
If you-ve received a few inexplicable denials from your payer, the problem might be due ... Read more
Reader Questions:
Submit Claim for Non-Par, Too
Question: How do you submit claims to Medicare for a non-par provider? All my physicians... Read more
Submit Claim for Non-Par, Too
Question: How do you submit claims to Medicare for a non-par provider? All my physicians... Read more
Reader Questions:
Apply Locums Tenens for Physician Absence
Question: We have a temporary physician coming in for a couple of weeks to cover patient... Read more
Apply Locums Tenens for Physician Absence
Question: We have a temporary physician coming in for a couple of weeks to cover patient... Read more
Reader Questions:
Prove Separate Service Before Billing E/M in Global
Question: If my doctor is charging an E/M and a FNA, is modifier 59 appropriate? Our pay... Read more
Prove Separate Service Before Billing E/M in Global
Question: If my doctor is charging an E/M and a FNA, is modifier 59 appropriate? Our pay... Read more
Reader Questions:
Check Secondary Payer Copay Rules
Question: A patient's primary insurance had a $15 copay, which we collected from the pat... Read more
Check Secondary Payer Copay Rules
Question: A patient's primary insurance had a $15 copay, which we collected from the pat... Read more