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 […]

Read More

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 […]

Read More

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. […]

Read More

Medical billing companies work with claims and services offered by a healthcare organizations or providers and send them directly to insurance companies or individuals responsible to pay the bill. If payments are not issued in due time, the billing company shall follow up to secure payment. Services that a medical billing company can provide include: […]

Read More