Billing

Billing

2020 Medicare Physician Fee Schedule: TCM Expands, E/M Confirmed

If you don’t have time to comb through the 2020 Medicare Physician Fee Schedule Final Rule, you’re not alone. Most physicians and staff are simply too pressed for time to figure out exactly what parts of the rule are relevant to their practice and specialty. If that’s the case — don’t worry. We’ve sussed out […]
Published Date: November 8, 2019
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OIG Watch List: Protect Payments from Urine Drug Test Audits

The Office of Inspector General (OIG) added to its Workplan items that contractors will audit or evaluate with a more critical eye. If you bill for urine drug test or speech-language pathology services to Medicare beneficiaries, now’s the time to weigh your compliance risk and fix any issues. OIG Scrutinizes Urine Drug Test, Speech-Language Pathology […]
Published Date: October 31, 2019
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6 Easy Steps to Unlock Your Well Woman Exams Pay Up

Getting reimbursed for preventive well woman exam claims is tricky – not all third-party payers reimburse for these services and the coverage rules vary for the payers that do. You can’t afford to mess up the ABN or the allowed codes. Remove barriers to get the reimbursement you deserve by following a handy step-by-step guide. […]
Published Date: October 24, 2019
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Medicare Diabetes Prevention Program MDPP

CMS Releases 2020 Payment Rates for Medicare Diabetes Prevention Program MDPP

CMS has released the 2020 payment rates for HCPCS codes for the Medicare Diabetes Prevention Program (MDPP). A provider can receive payments of varying amounts close to $700 per beneficiary. New MDPP 2020 payment rates go into effect Jan. 1. While the rate change is minimal, every dollar makes a difference towards an ounce of […]
Published Date: October 23, 2019
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Attorney General Moody’s Medicaid Fraud Control Unit Arrests 19 in Regional Takedown

TALLAHASSEE, Fla.—Attorney General Ashley Moody today announced the completion of a statewide Medicaid fraud takedown. The Attorney General’s Medicaid Fraud Control Unit executed 19 arrests for fraudulently billing Medicaid more than a million dollars. The arrests culminated from 14 different cases covering a wide range of charges, including: aggravated identity theft, conspiracy to commit health […]
Published Date: October 22, 2019
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MAT Opioid

Prep Now to Get Paid for MAT Opioid Programs under New CMS Rule

You may have added Medicare reimbursement opportunities to rejoice about come the new year. In the final rule for the Medicare Physician Fee Schedule, CMS has plans to expand coverage for opioid use disorder (OUD) treatment services to increase access to treatment, including medication-assisted treatment (MAT Opioid Treatment Programs). How to Get Paid for MAT […]
Published Date: October 18, 2019
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CPT Code 59400

Global Billing Growing: Capture Charges Beyond CPT Code 59400 for Bundled Care

Insurance trends are shifting from fee-for-service models to global billing structures including in the area of maternity care pricing: a flat rate fee for (almost) all services rendered to cover the entire pregnancy billed with one code such as CPT code 59400. Correctly including what is part of a global billing model – and what […]
Published Date: October 1, 2019
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CMS ASC Approved Procedure List

CMS ASC Approved Procedure List Challenges: Look to HR 4350

If your practice has an Ambulatory Surgical Center (ASC), you’re part of the millions Medicaid saves every year. However, you reap fewer benefits than Hospital Outpatient Departments (HOPDs). A new bill on the table could serve to ease some of the burden your ASC faces, especially relating to the variable CMS ASC approved procedure list. […]
Published Date: September 17, 2019
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Fee-for-compensation

Bust 3 Myths to Boost Pay for Your Fee-for-Compensation Physicians

Are you billing for fee-for-compensation services correctly? Many practices aren’t — and that means leaving money on the table. In today’s healthcare market, that’s not something you can afford to do. Unfortunately, fee-for-compensation billing is often misunderstood, so many practices aren’t getting all the reimbursement they deserve. Plus, incorrect or non-compliant billing practices can catch […]
Published Date: September 15, 2019
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