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Outsourcing Could Solve Practice Management Challenges

Recently Healthcare Financial Management Association (HFMA) conducted a survey on day-to-day challenges faced by small practice owners. This survey revealed that frontline healthcare workers are not...

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Key Elements of EMS Documentation

Documentation is one of the least favorite parts of Emergency Medical Services (EMS) providers’ job. However, next to patient care, it is one of the most important things. Many EMS providers do not...

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Avoiding Denials of Ambulance Services

Recently CMS published Medicare Fee-for-Service (FFS) improper payment date for ambulance services for the 2020 reporting period. For this reporting period, the improper payment rate for ambulance...

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Determining Drug Coverage for Original Medicare

Determining Medicare Drug Coverage While billing for Skilled Nursing Facility (SNF) or for hospital billing, billers always make the mistake of considering the wrong Medicare drug coverage. For...

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Avoiding Improper Medicare Payments for Surgical Dressings

Improper Payment Reasons Durable Medical Equipment (DME) suppliers of surgical dressings and physicians submit claims for surgical dressings and CMS covers it under the surgical dressings benefit i.e.,...

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Getting Paid for Telehealth Physical Therapy

Basics of Telehealth Physical Therapy During the COVID-19 pandemic, the federal government has broadened access to telehealth services including physical therapy. With revised billing guidelines, all...

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Guidelines to Avoid External Payer Audit

Understanding External Payer Audits An external payer audit is an examination of a healthcare practice’s finances or processes conducted at the will of payers. These payers are either the government or...

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Reducing E/M Services Claim Denials

E/M Services Denial Reasons As per the Centers for Medicare & Medicaid Services (CMS) data, approximately 15 percent of evaluation and management (E/M) services are improperly paid and accounted...

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Avoiding Prior Authorization Denials

The burden of Prior Authorization According to a recent survey from the American Medical Association (AMA), prior authorization creates an administrative burden for healthcare practices, negatively...

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Billing Guidelines for Wound Care in 2022

Basics of Wound Care Active wound care procedures are performed to remove devitalized and/or necrotic tissue to promote healing. Debridement is the removal of foreign material and/or devitalized or...

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Telemedicine Coverage and Reimbursement in 2022

Increased Scope of Telemedicine Telemedicine and telehealth describe the use of telecommunication tools including the Internet, video, and email to exchange information in the context of health care...

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Billing for Surgical Assistants: What you should know?

Surgical Assistants Practices lose insurance reimbursement by incorrectly billing surgical assistants. In such cases, the major reason for claim denials is to use the wrong modifier/ not use the...

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Selecting E&M Based on Time

Prior to 2021, the time associated with CPT codes 99202-99215 was based specifically on the typical face-to-face time the physician/qualified health care professional (QHP) spent on the day of the...

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HIPAA Compliant Ophthalmology Medical Billing Services

Basics of HIPAA Medical Billers and Coders (MBC) being a leading medical billing company manages all revenue cycle management activities in HIPAA compliant way. In this article, we shared the basics of...

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Billing Medicare for Initial Preventive Physical Examination

Initial Preventive Physical Examination (IPPE) The initial preventive physical examination (IPPE) is a preventive visit also known as a ‘Welcome to Medicare Preventive Visit’. Medicare pays for one...

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Guidelines for Billing Medicare for Ambulance Transportation

Medicare Coverage for Ambulance Transportation  Medicare Part B covers emergency ambulance services and, in limited cases, non-emergency ambulance services. Part B covers medically necessary emergency...

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Understanding Cataract Co-Management Billing

Billing and coding for cataract co-management can be tricky. It’s important that all parties involved should get accurately reimbursed for their time and expertise. To explain cataract co-management...

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Understanding of No Surprises Act & Good Faith Estimates for 2023 Billing

Basics of No Surprises Act The No Surprises Act went into effect on January 1, 2022. This Act is aimed at reducing ‘surprise bills’ to patients in the context of services provided at hospitals and...

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MBC can help in Prioritizing the Patient Experience

Significance of Patient Experience There is no question that patient experience is a huge factor when it comes to the success of your practice. In case of negative patient experience, their...

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General Coding Guidelines for ICD-10-CM

ICD-10-CM Basics Selecting accurate diagnosis codes using ICD-10-CM is challenging due to the availability of more than 68,000 codes. In this article, we shared general coding guidelines for ICD-10-CM...

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