Author: Billin_Admin

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 factor reduction of 3.75% from $34.89 in 2021 to $33.58 in 2022 for a $1.31 reduction. With the proposed budget neutrality adjustment to account for changes in RVUs (required by law), and expiration of the 3.75 percent payment increase provided for CY 2021 by the…

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 code(s) submitted is/are not covered under an LCD or NCD. Reason for this Medical Necessity Denial: The denial is based on the Medical necessity i.e. the diagnosis code may be insufficient to support medical necessity as per the NCD / LCD guidelines. How to check…

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 that have permanently expanded telehealth coverage and access beyond the coronavirus pandemic. Both bills were already approved by the state’s Legislature in June, 2021. HB 4 opens the door for Medicaid and public health plans to use connected health platforms for preventive health and wellness…

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. Any temporary changes that were put in place to support practices and facilities from March 19, 2020 through June 30, 2021 will no longer apply. This includes: Credentialing is required for all licensed individual health care professionals in order to participate in the UnitedHealthcare networks…

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: • Claims processing• Submitting requests for health benefits• Entering demographic and insurance details from the patient into computer systems• Verifying the insurance coverage of a patient• Reconciling billing and payable accounts• Acting as accounts receivable by invoice collection• To ensure their accuracy, auditing medical billing…

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 just had what is known as balancing or extra billing. If the patient has a specific reason to assume that there would be no balance billing, it’s called “surprise billing” in some cases. What is balance billing? A balance bill can be concerning, especially if…

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 States healthcare system and what are the steps in the medical billing process? What are the steps in the medical billing process? There are several steps in the medical billing process, below are the most common steps to understand the medical billing process in a…

To understand the new politics stance and other pro nationals of recent times, we should look to Silicon Valley and the quantified movement of the latest generation. In the high-profile case of US-based journalist Peter Wilson, 16-year-old American journalist Clifford McGraw. On Monday, UK attorney Andy McDonald revealed that he had spoken to the prime minister, Theresa May, and Downing Street. Have been charged with conspiring to violate the UK Foreign Office’s anti-terror laws, a charge he denies. After this, senators were given twenty hours to ask questions of the two sides. Anthony Zucker: Why there could be a speedy…

To understand the new politics stance and other pro nationals of recent times, we should look to Silicon Valley and the quantified movement of the latest generation. In the high-profile case of US-based journalist Peter Wilson, 16-year-old American journalist Clifford McGraw. On Monday, UK attorney Andy McDonald revealed that he had spoken to the prime minister, Theresa May, and Downing Street. Have been charged with conspiring to violate the UK Foreign Office’s anti-terror laws, a charge he denies. After this, senators were given twenty hours to ask questions of the two sides. Anthony Zucker: Why there could be a speedy…

To understand the new politics stance and other pro nationals of recent times, we should look to Silicon Valley and the quantified movement of the latest generation. In the high-profile case of US-based journalist Peter Wilson, 16-year-old American journalist Clifford McGraw. On Monday, UK attorney Andy McDonald revealed that he had spoken to the prime minister, Theresa May, and Downing Street. Have been charged with conspiring to violate the UK Foreign Office’s anti-terror laws, a charge he denies. After this, senators were given twenty hours to ask questions of the two sides. Anthony Zucker: Why there could be a speedy…