Medicare is a subsidized health care insurance program given by the U.S government, including people age 65 or above, younger who meet specific eligibility criteria, and individuals suffering from particular diseases. History 36th American president Lyndon B. Johnson signed a bill into law on July 30, 1965, that helped initiate both Medicare and Medicaid. Medicare … [Read more...] about Insurance Guidelines About Medicare
Resources
What Do You Need To Know About Insurance Policy And Filing A Claim?
Insurance policy An insurance policy is a legal contract between the insurer and the insured person(s), business, or organization.Everyone should read their insurance policy carefully to ensure that it fulfills their needs and that you understand your and the insurance company's duties in the event of a loss. Many insureds buy a policy without understanding what is covered, … [Read more...] about What Do You Need To Know About Insurance Policy And Filing A Claim?
Understanding & Navigating Your Insurance Policy
Insurance is an essential tool for gaining access to the necessary treatment to recover. Health insurance can help pay for mental health care needs such as checkups, specialist visits, emergency care, and hospitalization. In most cases, insurance will cover the entire cost of medical services. Getting insured or reviewing your current insurance plan may appear challenging, … [Read more...] about Understanding & Navigating Your Insurance Policy
Different Insurance Policies In Medical Billing
Choosing the correct type of health insurance policy for your company is critical. Different types of health policies are developed for various purposes to complicate matters further. It is essential to understand the numerous insurance policies to effectively code and bill for medical practices. There appears to be an insurance plan for almost every scenario, and providers see … [Read more...] about Different Insurance Policies In Medical Billing
CDT Codes For Occlusal Appliances
What is an occlusal appliance? An occlusal appliance is a detachable device, usually manufactured of hard acrylic, that fits over the occlusal and incisal surfaces of one arch's teeth, allowing precise occlusal contact with the teeth of the opposing arch. It's also recognized as an occlusal splint, bite guard, night guard, interocclusal appliance, or orthotic. Uses Of … [Read more...] about CDT Codes For Occlusal Appliances
What Do You Need To Know About Qualifying Payment Amount and No-Surprise Act Guide
The qualifying payment amount (QPA) is the foundation for determining individual cost-sharing for products and services covered by the balance-billing provisions under the No Surprises Act (NSA). The qualifying payment amount is used to calculate the patient's cost-sharing amount for emergency and non-emergency services covered by the No Surprises Act (NSA). In addition, in the … [Read more...] about What Do You Need To Know About Qualifying Payment Amount and No-Surprise Act Guide
CPT Codes For Remote Patient Monitoring(RPM)
CPT codes for remote patient monitoring have been created by the Centers for Medicare & Medicaid Services (CMS). Proper coding of remote patient monitoring services is one of the most crucial measures practices must take to receive this reimbursement. General requirements Physicians and practitioners can provide RPM services to acute and chronic disease patients. … [Read more...] about CPT Codes For Remote Patient Monitoring(RPM)
CPT Code Of Pain Management 2022
Chronic pain management is a difficulty for both physicians and patients. Physicians employ various modalities, including interventional treatments and noninvasive approaches to control the pain and assist patients in managing the condition. Providers must assign proper codes on claims to indicate the patient's need for which the services were delivered when they adopt … [Read more...] about CPT Code Of Pain Management 2022
The No Surprises Act (NSA) and What It Means for Emergency Rooms
The 2020 No Surprises Act (NSA) introduced new federal protection against unexpected medical bills and balance billing, the majority of which went into effect on January 1, 2022. The primary No Surprises Act requirements are summarized below and what they imply for you. Prevents balance billing for out-of-network emergency care (given in hospital EDs and independent … [Read more...] about The No Surprises Act (NSA) and What It Means for Emergency Rooms
What is the correct way to utilize CPT CODE 99214?
99214 CPT CODE - Office/Other Outpatient Services (Established Patients) Medicare only covers the medically required component of the appointment. Even if a comprehensive note is created, only the necessary services for the patient's condition at the time of visit can be included in calculating the level of an E/M code. A chronological narrative of the progression of the … [Read more...] about What is the correct way to utilize CPT CODE 99214?
Family Practice CPT codes
For family physicians, 2020 started with a slew of significant billing and coding changes. According to a study, family physicians could not bill for all of the services offered in most of their visits because CPT codes for medical billing did not cover the services. Medical billing services for family practices guarantee that suppliers do not miss out on the opportunity … [Read more...] about Family Practice CPT codes
Medical Coding: The Key to Minimizing Administrative Costs and Eliminating Claims Denials
The COVID-19 pandemic has placed an unparalleled strain on global healthcare systems. On the other hand, the pandemic has speeded up the digitization of healthcare operations. That is particularly true for health facilities and other primary care providers' billing and coding functions, with error-free, coherent documentation and claims processing becoming the main factors for … [Read more...] about Medical Coding: The Key to Minimizing Administrative Costs and Eliminating Claims Denials
How to decode common Denial Codes in a Medical Practice
We've dug into most prevalent denial reason codes in these unbelievable times to shed light on solutions that help your practice avoid expensive denials. Claims denials are widespread, and they have a considerable impact on your bottom line. We've compiled a list of the top five most common denial reason codes and provided solutions to help you decrease the number of denials … [Read more...] about How to decode common Denial Codes in a Medical Practice
Understand commonly used Modifiers and how they affect reimbursements
What are Modifiers? According to the AMA and the CMS, a modifier is a way to record or signify that a service or process has been performed and changed by some particular condition but has not changed in definition. It may also offer additional information on services that have been conducted more than once or services that have happened unexpectedly. When not all of the … [Read more...] about Understand commonly used Modifiers and how they affect reimbursements
Avoiding Common Modifiers Misuse
One of the most common reasons medical claims are refused is the absence of modifiers or the use of incorrect modifier combinations. Accurate treatment coding is essential, but it is also critical to add modifiers when applicable and to use the proper one for the code you are using. When your claim is refused, it not only delays payment but may result in non-payment. … [Read more...] about Avoiding Common Modifiers Misuse