Though physicians spend a lot of time counseling patients, they usually tend to overlook the reimbursement opportunity for this service. According to CPT guidelines, medical billing and coding for evaluation and management (E&M) services revolves around 7...
Avoid the Perils of Undercoding with Medical Billing Services
Undercoding is as much a problem as overcoding and occurs when the CPT and HCPCS codes billed do not indicate the full scope of the work performed by the physician or facility. In addition to lost revenue, undercoding is likely to make you a target for audits....
Medicare’s New Health Insurance Market Place Rules – Impact on Risk Adjustment/HCC Coding
The Centers for Medicare and Medicare (CMS) has released new health insurance market place rules which will take effect from January 17, 2017. Referred to as the “payment notice,” the rule is an annual CMS omnibus rule that covers all the major changes that CMS plans...
Anesthesiology ICD-10 Documentation Tips
Success in physician billing services under ICD-10 depends on proper clinical documentation and this is critical for anesthesiology. In addition to obtaining higher reimbursement, changing healthcare payment models also make it necessary for anesthesiologists to...
Dental Billing Fraud and Abuse – Know the Facts
Dental practices are under increasing scrutiny by Medicare, commercial insurance companies and regulatory bodies after recent reports of dental billing fraud and abuse. While partnering with a dental billing company can help maintain practice integrity and compliance,...
Many Patients may be Underinsured – Medical Eligibility Verification is Crucial
The Affordable Care Act (ACA) improved Americans’ access to healthcare, but a recent report in the New York Times highlights the fact that many people may be still underinsured. This makes medical eligibility verification all the more important for healthcare...
Outsourcing Medical Billing can help Radiologists Stay Ahead of the Curve
Radiology reimbursements have been impacted by the shift to value-based care and new payment models. That’s why many practices and imaging centers are looking to experienced companies that outsource medical billing services to stay ahead of the curve. In January 2015,...
Natural Language Processing Unveils HCC Coding and Reimbursement Opportunities
Utilizing Natural Language Processing (NLP) based technology and big data analytics, the University of Pittsburgh Medical Center (UPMC) health plan has successfully processed millions of clinical documents to accurately identify risk adjustment or HCC coding...
Can ICD-10 Medical Codes Help Chiropractors Document Winter Vehicle Accidents?
ICD-10 medical coding includes documenting a range of external causes for injury, and you may need to use these specific codes especially during the winter season. Driving during winter months is dangerous. The leading cause of death during winter storms is...
Spine Surgeon Alert: Increase Revenue by Reporting Consultations of Non-Medicare Patients
Increasing revenues for non-Medicare patients for Spinal practices or for medical billing outsourcing companies dealing with medical billing for spinal surgeons is always important. While spinal practices are well aware that Medicare eliminated consultation codes...