CMS releases 2nd Quarter PTP and MUE Version Updates The Centers for Medicare & Medicaid Services (CMS) recently released the April 2018 code pair tables for providers to review before filing claims. CMS developed the national correct coding initiative (NCCI) to promote correct coding methodologies and to control improper coding that leads to inappropriate payment…
Category: Medical Billing and Co…
Identify and Overcome Billing and Coding Reimbursement loss
Spine and orthopedic surgery practices often face revenue building challenges due to billing and coding errors. The culprit is simply confusion in changes to procedure or misunderstanding of the strict guidelines and CPT coding criteria. MEREM Healthcare Solutions offers insight for practice administration to improve their revenue through detailed coding and accuracy in the billing…
Billing for Mid-level Providers
There is a lot of confusion and questions about how and when to bill for mid-level providers. If you have a new mid-level in your practice for the first time, then you might not know what “incident-to” billing is. You may not even know what the difference is between billing for a mid-level provider versus…
Are you billing “incident to” services correctly?
Lately, we have noticed a lot of confusion from providers regarding billing “incident to” services. We have come across many practices that don’t know the guidelines and have questions on how to bill for incident-to-services. Let’s review the basics. What is incident to services? “Incident to” is a billing policy for mid-level providers to bill…
Medical Billing and Coding Services – CMS Update on MIPS
An Important CMS Update on MIPS Participation Under pressure from the MGMA and other physician advocacy groups, CMS will be sending letters to physician practices throughout the month of May with important, practice-specific information regarding eligibility to participate in the Merit-Based Incentive Payment System (MIPS) at the group/individual level for the performance year 2017.
Making Sense of MACRA/MIPS
If you are like many providers, you were probably just getting used to the CMS programs PQRS and Meaningful Use when they passed their latest payment reform policy—MACRA. Now, you may find yourself confused and concerned with how this new program will affect your practice.
ICD-10: Holiday Edition
Attention physicians and medical professionals- the holidays are upon us. Fear not; we have you covered with an ICD-10 cheat sheet listing a few codes you may see throughout the season.
Medical Auditing
Have you found yourself thinking of ways to improve your healthcare organization? Updating your clinical documentation through medical auditing is the best way for improvement. An audit assists in detecting incorrect coding practices and it could be considered by federal agencies when questioning if steps were taken to avoid and detect fraud and abuse. What…
Physicians- What Is Your Hospital Value?
What is your value to your hospital? Merrit-Hawkins, a national physician search firm, recently released a study regarding physician referral impact as it relates to revenue for hospitals. For the study, researchers from Merritt Hawkins asked hospital CFOs to quantify the amount of revenue physicians in 18 different medical specialties generated for their affiliate hospital in the…
Electronic Payment Posting
Many practices are utilizing electronic payment posting and many insurances now use this as their only form of receiving payment. There are still several practices that have not taken advantage of this process. If your practice has not adopted electronic payment posting, consider these points: • As stated above, many insurance companies are using this…
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