Medical Billing Archives - Page 21 of 30

The Challenges of Billing Observation Correctly

Observation, outpatient outlier payments, and the Inpatient-only List: Getting it right is not always easy. On this week’s Monitor Mondays we had a robust discussion about Condition Code 44. And on June 9, I will be presenting a webinar on the nebulous concept of “outpatient” service in a bed. Both of these have one thing […]

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Choose the best EHR and medical software for your practice

Diverse medical software — EHRs, billing software, patient relations tools — has already become essential for the efficient operation of any healthcare provider, be it a cross-state healthcare network or a small private practice. Though providers can probably make use of any type of medical software, the financial resources they can invest in medical solutions […]

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How to correctly document and bill for patient e-visits

Q: The providers in our clinic want to start billing e-visits.Can they bill for all the communication between the provider and patient through our online portal? A: As you venture into billing e-visits, on-line visits, digital visits – however you’d like to refer to them – let’s review the required elements for these types of […]

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Learn About OPPS Changes in July Update

Please be mindful that several coding and billing alterations pertaining to outpatient claims have been backdated to either April or January. Numerous modifications to Medicare’s Outpatient Prospective Payment System (OPPS) in the July update closely mirror those in the Medicare Physician Fee Schedule Database (MPFSDB) update for the same quarter. These include the introduction of […]

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No Surprises Act blocks 2 million surprise medical bills in first two months of 2022

The federal No Surprises Act (NSA) prevented more than 2 million surprise medical bills for the first two months of 2022 – far more than federal regulators initially estimated. If the trend continues, the law will block more than 12 million surprise bills to patients this year, according to a projection from AHIP and the […]

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Take the Complexity Out of Behavioral Health Coding

The secret to ensuring both proper payment and compliance is in the details. Why is mental health coding so complex? Laurie Bouzarelos, MHA, CPC, asked and answered that question in her presentation “Coding and Billing for Psychiatry and Outpatient Mental Health Providers” at AAPC’s virtual HEALTHCON 2022, March 27-30. Bouzarelos manages to take much of […]

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BMA Supports Bill on Medicare Advantage Prior Authorizations

The bill would aim to standardize processes and require greater oversight on Medicare Advantage plans’ utilization and denial of prior authorizations. Better Medicare Alliance (BMA) has endorsed HR 3173, the Improving Seniors’ Timely Access to Care Act, a law that seeks to reform prior authorization in Medicare Advantage. “When it comes to the use of […]

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MGMA Requests Updates to Independent Dispute Resolution Portal

The organization recommended CMS update the independent dispute resolution portal to improve communication between disputing parties and adjust the form field requirements. The Medical Group Management Association (MGMA) has asked CMS to update the federal independent dispute resolution (IDR) portal to streamline the arbitration process for determining an out-of-network payment rate for a surprise medical […]

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No Surprises Act May Have Blocked 2M Surprise Billing Claims

The No Surprises Act came into effect in December 2021, potentially averting countless instances of unexpected billing claims within its initial two months of implementation. By May 24, 2022, the No Surprises Act had already thwarted over two million cases of surprise billing claims during its initial two-month span, as per a survey conducted by […]

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Medicare advantage prior authorizations are often unnecessarily denied

A report by the Office of Inspector General (OIG) raises concerns about organizations prioritizing profits over patient access to care. Medicare Advantage organizations (MAOs) often delay or deny services for medically necessary care, even when prior authorization requests meet coverage rules, according to a report by the OIG. A concern with the Medicare Advantage […]

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Category: Medical Billing

The Challenges of Billing Observation Correctly

Choose the best EHR and medical software for your practice

How to correctly document and bill for patient e-visits

Learn About OPPS Changes in July Update

No Surprises Act blocks 2 million surprise medical bills in first two months of 2022

Take the Complexity Out of Behavioral Health Coding

BMA Supports Bill on Medicare Advantage Prior Authorizations

MGMA Requests Updates to Independent Dispute Resolution Portal

No Surprises Act May Have Blocked 2M Surprise Billing Claims

Medicare advantage prior authorizations are often unnecessarily denied

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