Tag: medical-billing

4 Strategies For Accurate Medical Coding & Denial Prevention

4 Strategies For Accurate Medical Coding & Denial Prevention

4 Strategies For Accurate Medical Coding and Denial Prevention Payers typically deny evaluation and management codes (E/M code) on the back end of the billing process, which can cause costly reimbursement recoupments, according to Medical Economics. Four tips to avoid denials caused by inaccurate E/M levels: Make sure the E/M code supports the specific patient encounter. […]
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Boost Revenue By Getting Coding Right

Boost Revenue By Getting Coding Right

It’s every physician’s worst nightmare: Receive payment for services rendered, but then a payer identifies an aberrant pattern in claims data, audits the records, decides it has overpaid the practice, and recoups those funds. That money you already allocated for overhead, staff salaries, bonuses, or new medical equipment? Gone. With one post-payment audit, you now […]
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Improve Patient Collections Through Billing Transparency

Improve Patient Collections Through Billing Transparency

An overwhelming majority (92 percent) of patients want to know their payment responsibility prior to visit. This statistic, from InstaMed’s seventh Trends in Healthcare Payments Report, highlights the recent shift in patient financial engagement. Patients have become consumers who seek transparency and flexibility when paying for healthcare expenditures. However, medical groups are lagging when it comes to meeting […]
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CMS Delays OPPS Claim Edits For Off-Campus Provider-Based Depts

CMS Delays OPPS Claim Edits For Off-Campus Provider-Based Depts

OPPS claim edits slated to take effect this month will now start in October to give providers more take to adjust to billing changes for off-campus provider-based departments. CMS is postponing the implementation of outpatient prospective payment system (OPPS) claim edits that would require hospitals and health systems with multiple locations to list provider addresses […]
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Medicare Beneficiary Identifiers

The New Medicare Cards: What You Need to Know About Medicare Beneficiary Identifiers (MBIs)

To protect the privacy of Medicare recipients and prevent fraudulent use of Social Security Numbers (SSN), a new, unique 11-character Medicare Beneficiary Identifier (MBI) is replacing the SSN-based Health Insurance Claim Number (HICN) for Medicare transactions such as billing, eligibility status, and claim submissions. The MBI does not change Medicare benefits. What’s Behind The Change? The […]
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Change To RT And LT Modifiers Use

Change To RT And LT Modifiers Use

The Durable Medical Equipment Medicare Administrative Contractors (DME MAC) are changing the requirement that medical coders to use the right (RT) and left (LT) modifiers for certain HCPCS codes, and that the modifiers be used when billing two of the same item or accessory on the same date of service and the items are being used bilaterally. The […]
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CMS Releases FY 2020 ICD-10-PCS Codes Set

CMS Releases FY 2020 ICD-10-PCS Codes Set

CMS released the fiscal year (FY) 2020 ICD-10-PCS changes on Friday, May 31, which include two code revisions, 734 additions, and 2,056 invalidations. The files include information on ICD-10-PCS updates that all inpatient coders must use for discharges occurring from October 1, 2019, through September 30, 2020. The total number of ICD-10-PCS codes for 2019 was 78,881. […]
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Customize Patient Financial Encounters For Revenue Cycle Success

Customize Patient Financial Encounters For Revenue Cycle Success

Healthcare is a top priority for American voters and there aren’t dramatic differences by ideology, according to a new survey. Adopted from the marketing industry, customer segmentation allows health systems to further customize the patient financial experience and help them get paid. Key Takeaways Tailor billing strategies and patient payment options to a financial situation […]
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Medicare Payments For Top 10 ASC Codes

Medicare Payments For Top 10 ASC Codes Through 2019

Medicare payments for the top 10 current procedural terminology codes performed by ASCs are expected to remain relatively stable in 2019 compared to 2018, according to VMG Health. 66984: Cataract surgery with insertion of intraocular lens prosthesis (one-stage procedure), manual or mechanical technique Estimated 2017 payments: $1,172 Estimated 2018 payments: $1,206 Estimated 2019 payments: $1,182 45380: […]
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