Billing

Billing

Billing Errors False Claims success

Dodge Thousands in Penalties by Owning & Reporting Billing Errors

The False Claims Act makes you – and your provider – responsible for medical billing errors and misbilling claims even if you use a billing company. The massive fines – more than $20,000 per violation – can cripple your practice. This quick start guide gives you key ways to prevent accidentally misbilling claims so your […]
Published Date: January 22, 2020
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Billing Waivers

5 Steps Make Financial Waivers a Good, Not Risky Deed

QUESTION: We serve a large volume of underprivileged patients who can barely afford to eat. Our doctors often want to help them by waiving their deductibles and co-pays. Could we get in trouble for doing this “good deed”? Cookeville, TN Subscriber ANSWER: Waiving a patient’s co-pay, deductible, or co-insurance can put your practice at risk […]
Published Date: January 16, 2020
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2020 CMS Telemedicine: Bill More Services From Eased Locale Rules

The recently released 2020 CMS Telemedicine Policy Final Rule’s changes just went into effect on January 1. Topping the list of improvements are new HCPCS codes, greater flexibility with telehealth location, and more telehealth benefit options. Count Home as Originating Site and 2 Other Sweeping 2020 CMS Telemedicine Changes This major final rule revises payment […]
Published Date: January 7, 2020
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Medicare Advantage Overpayments

Keep 60% Pay by Acting on Medicare Advantage Overpayments by Feb

If your physicians participate in Medicare Advantage Plans, keep a sharp eye on the mail. The final Medicare Advantage Overpayments letter is being mailed to practices the first week of January, and it contains a time-sensitive CMS settlement offer that you must act on this Winter or risk significant financial losses. Medicare Advantage Overpayments Letters […]
Published Date: January 3, 2020
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Does Medicare Fee Schedule Include E/M Changes for 2020?

QUESTION: I’m pretty nervous about the significant changes to the Evaluation and Management (E/​M) codes being made soon. The 2020 CMS Physician Fee Schedule goes into effect January 1, 2020, Does it contain the changes? ANSWER: The 2020 Medicare Physician Fee Schedule Final Rule confirms that the E/​M code changes completely take effect in 2021. […]
Published Date: December 31, 2019
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Balance mistakes

Don’t Let Everyday Billing Mistakes Land You in Legal Hot Water

Billing mistakes have more serious implications than you just seeing a decrease in your reimbursement.  Some of the most common billing errors can get your practice audited, and result in you paying massive violation penalties. Unfortunately, accurately billing for outpatient services is so much more complicated than just submitting a claim or sending an invoice. […]
Published Date: December 17, 2019
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Prior Authorization Billing

8 Tips to Speed Up Your Prior Authorizations and Reimbursement

Most patients are waiting for prior authorizations and that wait is negatively impacting their care. That’s why it’s critical that you get patient prior authorizations approved as quickly as possible — so you can get paid and your patients can get the treatment they need. The good news is that you can reduce your prior […]
Published Date: December 10, 2019
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Chronic Care Management

4 Ways CMS 2020 Final Rule Eases Chronic Care Management Billing

With COVID-19 delaying many patients care, your chronic care patients need more care now than ever. New rules mean that it’s gotten easier to get paid for chronic care management — but only if you’re up to date on the numerous changes and requirements that CMS has recently put in place. Reduced documentation requirements, new […]
Published Date: November 21, 2019
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Medicare ABN

4 Medicare ABN Steps to Promote Payment, Prevent Penalties

To secure payments and prevent audits, you must have your patients sign the correct version of the Medicare ABN form. Don’t risk fines and face write-offs by submitting the wrong form — educate yourself on when a Medicare ABN is mandatory or voluntary to protect your practice against unpaid claims. What is a Medicare ABN? […]
Published Date: November 19, 2019
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Chronic Care Management

Check 5 Capabilities to Bill Chronic Care Management

Update Notice: This information was updated for accuracy on May 19, 2021. This update reflects the 2021 CPT code changes for Chronic Care Management, specifically the replacement of code G2058 with code 99439. You’ll find this update in the “Facilitate Transitions of Care – Chronic Care Management Options” section below. Whether it’s diabetes, arthritis, or […]
Published Date: November 13, 2019
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