Role of Telehealth During COVID-19 Telehealth has proved to be an effective option to fight the outbreak of COVID-19. Telehealth services played a major role in preventing, diagnosing, treating, and controlling diseases during the COVID-19 outbreak. Even though an extended COVID-19 public health emergency (PHE) is scheduled for April 16, 2022, policymakers are thinking about […]

Running a financially stable medical practice is a challenging task. With the added challenges from the COVID-19 pandemic and changes in billing guidelines and reimbursement policies, things are getting tougher over time. Medisys Data Solutions is a leading medical billing company providing complete revenue cycle solutions for practices of various medical specialties. As we are […]

CMS has established two modifiers, CQ and CO, to indicate services furnished in whole or in part by a physical therapist assistant (PTAs) or occupational therapy assistants (OTAs), respectively. The modifiers are defined as follows: CQ modifier: Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant CO modifier: Outpatient […]

On 22nd April 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare enrollment and eligibility rules that would expand coverage for people with Medicare and advance health equity. This proposed rule would provide Medicare coverage the month immediately after enrollment, thereby reducing the uninsured period and expand access […]

Basics of Payment Posting Payment posting is an integral part of the revenue cycle management (RCM) of any healthcare organization. As the name suggests, payment posting involves posting the payments and their reconciliation. The billing team will post the received and denied payments into billing software against the submitted claim. If you have an efficient […]

Its quite common to receive a request for medical records from insurance carrier who is going to conduct an audit on your claims. Sometimes, in such external/payer audits, practices receive audit results like, medical necessity not supported; records include conflicting data; or notes are cloned. Audit report also says practice owes them huge amount of […]

The Health Insurance Portability and Accountability Act (HIPAA) was introduced in year 1996. As the name suggests, it was created to ensure that all ‘protected health information’ was appropriately secured and restricted access to be given only to authorized individuals. Another goal was to prevent healthcare fraud. Healthcare providers, health plans, and healthcare clearinghouses are […]

Accounts receivable (AR) is an important parameter for any practice’s revenue cycle management. More number of AR days indicate inefficiencies in your overall revenue cycle activities. Things can quickly go out of hand and providers require to write off significant amount as bed debt if not planned accordingly. In this article, we shared key parameters […]

Basics of Principal Care Management (PCM) In the Medicare Physician Fee Schedule final rule issued in November 2021, the Centers for Medicare and Medicaid Services (CMS) added four new CPT codes (99424, 99425, 99426, and 99427) in the category of Principal Care Management (PCM) to replace the two previous PCM codes (HCPCS codes G2064 and […]

Billing and coding guidelines for various medical specialities are constantly getting updated due different COVID-19 variants. Before delivering services, providers are really not sure about insurance coverage for that specific procedure. As Public Health Emergency (PHE) has extended beyond 16th April 2022 by 90 days, various waivers are continued, making no change in billing guidelines […]