Medical billing and coding changes happen every year. With the change in U.S. presidency from Barack Obama to Donald Trump, big changes are expected in the healthcare industry this year. According to a recent survey by Capital One Spark Business, cash flow and...
Many changes have affected primary care physicians (PCPs) in recent times. These include the shift to value-based care from the fee-for-service payment model, new regulatory requirements, the rise of new models of care, and the merging of independent practices with...
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....
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...
Insurance verification and authorization is the first and probably most important step in the medical billing process. Patient eligibility verification involves checking out the patient’s coverage before services are provided. While checking patients’ insurance...
