Tag: Medical Billing Services

2022-medicare-advantage-plan-overview-part-two-portfolio-strategy-and-leading-carriers

2022 Medicare Advantage Plan Overview, Part Two: Portfolio Strategy And Leading Carriers

  The ideal value chain for any industry or company is one built for lifelong customer retention and loyalty. One component of such a chain is a portfolio strategy that continues to offer maximum choice and affordability. For insurers in the Medicare market, this equates to a mix of plan designs and standalone prescription drug […]
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optum-partners-ssm-health-will-run-revenue-cycle-operations

Optum partners with SSM Health and will employ certain revenue cycle staff

To reduce care variation, SSM and Optum will use clinical technologies, advanced analytic and data-driven insights at the point of care. Certain SSM Health revenue cycle staff and hospital care management will become employees of Optum. They will continue to work in their current locations across Illinois, Missouri, Oklahoma and Wisconsin. WHY THIS MATTERS As […]
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As Revenue Cycle Management Expands, Automation Is Key

  In its simplest form, revenue cycle management is the process healthcare providers use to ask for, track, and collect revenue for services rendered to patients. But as medical billing gets more complex, revenue cycle management is expanding beyond the business office. At Jackson Hospital in Montgomery, Alabama, for example, revenue cycle management also includes […]
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no-surprises-act-notice-requirements-the-good-and-bad-news-for-providers

No Surprises Act Notice Requirements: The Good and Bad News for Providers

Surprise billing occurs when patients receive care from out-of-network providers without their knowledge. On July 1, the Biden Administration passed an interim final rule: the first portion of the “Requirements Related to the Surprise Billing Act,” in an attempt to curb excessive costs patients are required to pay in relation to surprise billing. The rule […]
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2021-e-m-changes-are-you-coding-unique-tests-properly

2021 E/M Changes: Are You Coding Unique Tests Properly?

Review the AMA’s updated definition of what constitutes a unique test. Many coders are asking the question, “What is a unique test?” As always, we must first turn to the guidelines to see how “test” is defined. In the original published guidelines, the American Medical Association (AMA) stated: “Tests are imaging, laboratory, psychometric, or physiologic […]
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ama-issues-more-covid-19-vaccine-codes

AMA Issues More COVID-19 Vaccine Codes

 The American Medical Association’s (AMA’s) CPT® Editorial Panel has released eight new COVID-19-related codes to report a new formulation of the Pfizer vaccine, a Moderna booster vaccine, and a Pfizer booster using either the new or old formulation. These codes are in addition to the four new CPT codes released last month and the many […]
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Gain Insight Into Billing an E/M With OMT

Reducing denials starts with understanding osteopathic manipulation as well as coding and coverage guidelines for this therapy. Is it appropriate to bill an evaluation and management (E/M) service when osteopathic manipulative treatment (OMT) is performed at the same visit? We must address a few key principles to adequately answer this question. I learned quickly, having […]
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