by Mary Pat Whaley | Jul 21, 2013 | Collections, Billing & Coding, Compliance, General, Medical Coding Education, Medicare & Reimbursement, Medicare This Week
Medicare recently started denying an increased number of claims because documentation submitted for diagnostic tests does not include signed test orders or evidence of intent (MD progress notes listing tests needed) and evidence of medical necessity...
by Mary Pat Whaley | Jul 15, 2013 | Collections, Billing & Coding, Compliance, Day-to-Day Operations, Medicare & Reimbursement
Most Medicare patients believe that Medicare pays for everything they need or want at their physician’s office, but there are services that either: Are only covered by Medicare for a specific medical need (for instance,...
by Mary Pat Whaley | Jul 7, 2013 | Collections, Billing & Coding, ICD-10, Medicare & Reimbursement
On June 17, 2013, the National Uniform Claim Committee (NUCC ) announced the approval of Version 02/12 1500 Health Insurance Claim Form (1500 Claim Form) that accommodates reporting needs for ICD-10. The Office of Management and Budget (OMB) has approved the 1500...
by Abraham Whaley | May 1, 2013 | Collections, Billing & Coding, Compliance, Day-to-Day Operations, Electronic Medical Records, Finance, Headlines, Medicare & Reimbursement, Quality
NOTE: CMS has just added additional presentations of the webinar below – please check the end of the article for added dates. MPW What is PQRS? The Physician Quality Reporting System (Physician Quality Reporting or PQRS) is a CMS reporting program...
by Mary Pat Whaley | Apr 11, 2013 | Collections, Billing & Coding, Medicare & Reimbursement, Medicare This Week
CMS has clarified the Place of Service (POS) codes that Physicians/Providers are to use on claims for services to patients starting April 1, 2013. This is more than a simple technical requirement, however. The correct place of service is directly tied to how much a...
by Abraham Whaley | Mar 31, 2013 | Collections, Billing & Coding, Day-to-Day Operations, Finance, Headlines, Medicare & Reimbursement
This is no April Fool’s Joke for medical practices and providers: starting Monday, April 1st, we will face a 2% cut in reimbursement for services due to the “sequester.” The sequester is the other half of the “fiscal cliff” that we...
