CMS Releases Proposed 2022 Medicare Physician Fee Schedule

CMS Releases Proposed 2022 Medicare Physician Fee Schedule with conversion factor of $33.58

On July 13, 2021, CMS has proposed a new rule that would update the Medicare Physician Fee Schedule and seek more health equity and telehealth utilization among physicians. The proposed rule for the Medicare Physician Fee Schedule would also implement a $33.58 conversion factor next year, a decrease of over $1 compared to 2021. Conversion …

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medical necessity denial

Medical Necessity Denial and Tips to Avoid it.

You might have received a medical necessity denial with claim adjustment reason code (CARC) CO50/PR50/N115 and description as these are non-covered services because this is not deemed a “medical necessity” by the payer. This denial reason code is received when a procedure code is billed with an incompatible diagnosis for payment purposes, and the ICD-10 …

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expanding telehealth and remote patient monitoring

Texas joins other states in permanently expanding Telehealth and RPM Services

Texas was set to approve legislation that would give the state’s Medicaid program and other public health plans more freedom to cover telehealth, RPM Services and allow audio-only telehealth services in some situations. In July, 2021, Governor Greg Abbott signed HB 4 and HB 5 into law this week, joining more than 20 other states …

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UnitedHealthcare credentialing

COVID-19 Credentialing Updates from UnitedHealthcare

Effective July 1, 2021, UnitedHealthcare resumes our standard credentialing and re-credentialing process and policies. These are consistent with National Council on Quality Assurance (NCQA) standards, as well as any specific state and federal regulations for participation in Medicare and Medicaid programs. Some states may have additional requirements as part of the credentialing and re-credentialing process. …

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What patients need to know about balance billing, is balance billing legal

What patients need to know about balance billing, is balance billing legal?

You are scheduled to a doctor, and your doctor ordered some tests. When you got treatment, the deduction was paid, and the remainder of the expense supposedly was covered by your insurance plan. Months later, though, you receive a letter from the health care provider about the cost not covered by your insurance company. You’ve …

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medical billing process

What is Medical Billing? and what are the common steps in medical billing process?

If we define Medical Billing it is basically a payment practice or process for a healthcare system of getting a physician paid for their services. More or less the same practice is followed in each country for the medical service provided to patients. But here we will discuss what is medical billing within the United …

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Best branding practices for Startups

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Ultimate Guide to Best Business Practices

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