Tag Archives: medical billing services

Patients’ Electronic Access to Health Information

Patients’ Electronic Access to Health Information

CMS Rule Building on the CMS Interoperability and Patient Access final rule (CMS-9115-F), this proposed rule would place new requirements on Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs, and Qualified Health Plans (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of health care data, and streamline […]

Reimbursement for telephone calls

Reimbursement for telephone calls

The COVID-19 pandemic has changed how physicians provide patient care in the outpatient setting rapidly and dramatically. During this Public Health Emergency, continuity of treatment of existing patients as well as maintaining a professional relationship with new patients has become difficult. To prevent COVID-19 exposure threats, many geographic areas are under “stay at home” or […]

OIG Targets Ambulance Transportation Services for Incorrect Medicare Billing

OIG Targets Ambulance Transportation Services for Incorrect Medicare Billing

In a recent round of demands it has initiated, the HHS Office of Inspector General is targeting ambulance transportation services even as services continue to struggle financially during the pandemic. OIG is now seeking financial damages from ambulance services that may have transported patients during a Part A stay from a qualified nursing facility. Legal […]

The health insurance affordability gap

The health insurance affordability gap

Targeted Medicaid growth, boosting state contributions to Affordable Care Act marketplace grants, or a hybrid of these options may help rise payer coverage affordability. Healthcare coverage is far away out of reach for many low-income Americans due to healthcare cost. But 3 innovative solutions for Connecticut might shed light on how to boost payer coverage […]

How to improve medical billing accuracy in CY 2021

How to improve medical billing accuracy in CY 2021?

The medical billing and coding process is a complex. When a patient presents with a significant medical history or complicated case billing can be time-consuming taking days, or months, to finalize. On top of that recent amendments to the U.S. healthcare system have added a variety of new challenges for both providers and patients. Various […]

Value-Based Care in Behavioral health

Value-Based Care in Behavioral health

Basics of Value-Based Care The value-based care model is designed to get more attention across the healthcare insurance industry. This is still being moderated to be perfect to deliver quality in care and not a quantity, care that will reward or penalize healthcare providers for patient or client outcomes. The ultimate goal of Value-Based Care […]

When is it appropriate to use modifier 90?

When is it appropriate to use modifier 90?

Reference (Outside) Laboratory When laboratory procedures are performed by a party other than the treating or reporting physician, the procedure may be identified by adding the modifier 90 to the usual procedure number. Modifier 90 should be appended to the procedure code representing the laboratory service that is being submitted to an outside laboratory for […]

What is advance beneficiary notice in medical billing

What is advance beneficiary notice in medical billing?

An advance beneficiary notice is a written notice (standard government form CMS-R-131) from Medicare, given to patient before they receive certain equipment or services, notifying patient that: Medicare may not provide reimbursement for that specific procedure or treatment Patient will personally responsible for complete payment if Medicare decline payment An ABN provide an opportunity to […]

Chiropractic CPT Codes

Chiropractic CPT Codes

Benefits of Chiropractic Insurance Billing When looking to increase your client base, your practice should be in-network with insurance this can help you reach new patients.  Patients looking for a new provider will often turn to their coverage to find who is going to accept their insurance. You will come up as an in-network provider, […]