Billing

Billing

Patient collections

5 Ways Practices Can Collect More From Patients to Bring in Cash

Medical practices spend hours every week working with insurers to collect reimbursement—but a much less discussed method of bringing cash into your practice is to maximize the money you bring in from patient collections. Ensuring that you collect copays, coinsurance and deductibles allows you to get the most reimbursement possible. Check out five ways to […]
Published Date: June 14, 2023
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Modifier 25

Cigna Delays Plan Requiring Medical Records With Modifier 25

UPDATE: Cigna has delayed the requirement described below, and it will no longer take effect on May 25. The company has not yet indicated when it will go into place, so keep an eye on the Healthcare Training Leader website for more information as this story develops. When you perform a minor procedure along with […]
Published Date: May 23, 2023
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Doctor pay

Report: Medicare Physician Pay Down 22% in Last 20 Years

When most businesses look to the future, they envision income and revenue rising incrementally over time, and medical practices are no exception. However, the results of a new survey show that when adjusted for inflation, Medicare physician pay dropped 22 percent between 2001 and 2021. That’s the word from the 2023 Physician Compensation Report by […]
Published Date: May 23, 2023
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Medication management

When You Can Bill 99605 for Rx Refills (and 4 Times You Can’t)

When patients need new or updated prescriptions, your provider probably puts a lot of work into ensuring that they get the right medications. In these situations, there may be occasions when you can bring in reimbursement for medication management using codes 99605-99607. Find out when this is an option and when it isn’t. When You […]
Published Date: May 22, 2023
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Prior authorization

How Medicare Advantage Prior Authorization Will Change in 2024

If your practice is like most, you’ve faced myriad headaches dealing with Medicare Advantage (MA) denials. In some cases, even when MA plans approve prior authorizations for certain services, you end up facing denied claims. Thanks to a new rule, however, that issue should go away in January. Background: On April 5, CMS issued a […]
Published Date: May 16, 2023
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Credit card on file

Compliantly Keep Credit Cards on File for Simpler Collections

Medical practices encounter dozens of touchpoints when patient collections can fall through the cracks. From patients who fail to show up for appointments and those who haven’t met their deductibles to people who simply have coinsurance to pay, the possibilities are endless. That’s why some practices choose to keep a credit card on file. While […]
Published Date: May 9, 2023
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Ambulatory surgery center

CMS Debuts 50 New Codes for ASCs – Here’s How to Use Them

Many practices are so busy trying to incorporate new CPT codes into their systems at the beginning of a new year that they may not notice other codes that have rolled out. Such has been the case for some providers this year, who focused so strongly on the changes to the E/​M code set that […]
Published Date: May 2, 2023
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Medicare appeals

5 Pitfalls to Avoid When Appealing Medicare Claims

No one likes to get a claim denial from Medicare. You have a few options in this situation: Either appeal the claim or eat the cost of the denied service. In most cases, filing Medicare appeals will allow you to boost the odds of getting paid, but you must avoid these five common pitfalls. 1. […]
Published Date: April 25, 2023
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Administrative fee

5 Administrative Fees Your Practice Could Charge to Earn More

Perhaps your practice has had success charging for no-shows or sports physical form completions—or maybe you’re just starting to investigate which administrative fees you might explore. Either way, there are many factors to consider if you’re thinking of charging administrative fees, but before you dot your I’s and cross your T’s, you might want to […]
Published Date: April 18, 2023
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Split/shared billing rules

Master 2023 Split/Shared Billing Rules With Key Tips & Examples

When a split/​shared visit takes place, both the physician and the nonphysician provider (NPP) perform part of an E/​M visit in the facility setting. The tricky part comes in when determining which provider should actually report the claim for the service. Check out a few tips so you can ensure your practice is following the […]
Published Date: April 11, 2023
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