Medisys Compliance

DECEMBER 23, 2022

The internet is ringing with the news of the CMS Updates Final rule for the 2023 Medicare Physician Fee Schedule. The finalized 2023 Medicare Physician Fee Schedule was announced by the Centers for Medicare & Medicaid Services (CMS) on November 1 2022. Medicare reimbursement for telehealth services.

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Healthcare IT Today

JUNE 29, 2023

The following is a guest article by Isaac Smith, Billing, Coding, and Reimbursement Specialist at Medcare MSO ASCs are types of medical facilities that are subject to stringent regulations. However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance.

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Medisys Compliance

JUNE 16, 2023

G0108 is a Medicare code used for the initial preventive physical examination, also known as the IPPE or “Welcome to Medicare” visit. This preventive service is designed to assess a beneficiary’s health status and provide essential preventive care measures.

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Medisys Compliance

OCTOBER 1, 2022

Navigating through the complex medicare guidelines can be a complex and overwhelming task, however, here is the good news, the entire process is merely about using the right CPT codes. However, one needs to be careful while billing as Medicare follows strict rules and regulations for time increments.

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Medisys Compliance

JULY 5, 2022

What is Medicare Overpayment? A Medicare overpayment exceeds regulation and statute properly payable amounts. When Medicare identifies an overpayment, the amount becomes a debt a healthcare provider owes the federal government. Based on this new information, CMS takes action to recover the mistaken Medicare payment.

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Medisys Compliance

JANUARY 30, 2023

The medical billing industry is a complex and ever-changing field, and it is crucial for healthcare providers and billing companies to stay compliant with government regulations. Let us discuss the top compliance issues in the medical billing industry, shall we? companies operating internationally.

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Medisys Compliance

JUNE 27, 2022

The Centers for Medicare and Medicaid Services (CMS) has announced a shift in its eligibility criteria for coverage of lung cancer screening using low-dose CT (LDCT), with implementation date of October 3 rd , 2022. If you need any assistance in billing for Medicare, contact us at info@medisysdata.com/ 302-261-9187.

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Medisys Compliance

JUNE 20, 2022

Under Fee-for-service (FFS) Medicare, home infusion therapy (HIT) involves the intravenous or subcutaneous administration of drugs or biologicals to an individual at home. Likewise, nursing services are necessary to train and educate the patient and caregivers on the safe administration of infusion drugs in the home.

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Medisys Compliance

MAY 31, 2022

End-Stage Renal Disease (ESRD) is a medical condition in which a person’s kidneys cease functioning on a permanent basis leading to the need for a regular course of long-term dialysis or a kidney transplant to maintain life. Beneficiaries may become entitled to Medicare based on ESRD. Medicare Secondary Payer (MSP).

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Medisys Compliance

AUGUST 1, 2022

Medicare enrollment is the first step towards becoming Medicare provider or supplier. CMS has shared complete process flow chart for successful Medicare enrollment. Being leading medical billing company, Medisys Data Solutions helped lots for providers and suppliers in successful Medicare enrollment.

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Medisys Compliance

MARCH 5, 2024

Understanding the Landscape of Cardiology Billing Cardiology billing encompasses a wide range of services, including diagnostic testing, interventional procedures, and ongoing patient care.

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Medisys Compliance

JUNE 7, 2022

Defining Medicare Secondary Payer (MSP). Medicare Secondary Payer (MSP) is the term generally used when the Medicare program does not have primary payment responsibility i.e., when another entity has the responsibility for paying before Medicare. When Medicare Pays First. Primary payers must pay a claim first.

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Medisys Compliance

JULY 26, 2022

Hospital administrators, physicians, and members of every healthcare office billing department know that if their practice or hospital provides services to Medicare patients, they must be prepared to potentially receive a request for an audit. Prepare for a Medicare Audit. Responding to an Audit Request.

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Medisys Compliance

JUNE 24, 2022

What’s a Medicare Administrative Contractor (MAC)? Its quite common for any provider to get confused while billing to Medicare for healthcare services, as they not billing to Medicare but to a MAC. million health care providers who are enrolled in the Medicare FFS program.

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Medisys Compliance

JULY 25, 2022

Recently published watchdog report found that private Medicare plans routinely rejected claims that should have been paid and denied services that reviewers found to be medically necessary. MAOs also denied payments to providers for some services that met both Medicare coverage rules and MAO billing rules.

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Medisys Compliance

FEBRUARY 20, 2023

Healthcare providers often get confused about the appropriate use of modifiers GA, GX, GY, and GZ while billing Medicare. GA modifier indicates that an Advance Beneficiary Notice (ABN) is on file and allows the provider to bill the patient if not covered by Medicare. Medicare does not pay for all health care costs.

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Medisys Compliance

APRIL 8, 2022

CMS has updated the Telehealth Services List to show minor changes due to various activities, such as the CY 2022 MPFS Final Rule and legislative changes from the Consolidated Appropriations Act of 2021. In this article, we briefly discussed these Medicare telehealth billing guidelines. Temporarily Added Telehealth Services.

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Medisys Compliance

MAY 19, 2022

During the COVID-19 public health emergency, any health care provider who is eligible to bill Medicare can bill for telehealth services regardless of where the patient or provider is located. Some important changes to Medicare telehealth coverage and reimbursement during this period include: Location. Cost-sharing.

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Medisys Compliance

APRIL 25, 2024

Introduction The ever-evolving world of healthcare billing can feel complex, and with the introduction of MACRA (Medicare Access and CHIP Reauthorization Act) in 2015, cardiology practices have faced some adjustments. MACRA replaced the previously used Sustainable Growth Rate (SGR) formula for Medicare physician payments.

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Medisys Compliance

JUNE 30, 2022

Medicare Coverage for MNT. The Social Security Act authorizes Medicare Part B coverage of Medical Nutrition Therapy services (MNT) for certain beneficiaries who have diabetes or a renal disease. Medisys Data Solutions is a leading medical billing company providing complete assistance in medical billing and coding.

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Medisys Compliance

JUNE 10, 2022

Medicare covers limited chiropractic services when performed by a chiropractor who is licensed or legally authorized to furnish chiropractic services by the State or jurisdiction in which the services are furnished. Medicare Coverage. American Medical Association. All Rights Reserved. Reference: [link].

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Medisys Compliance

MAY 5, 2022

On 22 nd April 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare enrollment and eligibility rules that would expand coverage for people with Medicare and advance health equity. Sections 120 and 402 of the CAA made two key changes to Medicare enrollment rules.

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Medisys Compliance

FEBRUARY 7, 2022

Medicare pays a physician for an Annual Wellness Visit (AWV) service. This visit is planned to develop or update a Personalized Prevention Plan (PPP) and perform a Health Risk Assessment (HRA) which is covered once every 12 months by Medicare. Medicare pays the IPPE costs if the provider accepts assignment.

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Medisys Compliance

JANUARY 20, 2022

The Centers for Medicare & Medicaid Services (CMS) recognizes that CCM services are critical components of primary care that promote better health and reduce overall health care costs. Billing Guidelines for Medicare Chronic Care Management. It may also help prevent duplicative practitioner billing.

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Medisys Compliance

OCTOBER 20, 2023

Emergency medical coders use standardized code sets like CPT (Current Procedural Terminology) and ICD-10 (International Classification of Diseases) to describe the services rendered. Detailed medical records provide the necessary support for justifying the level of care and ensuring appropriate reimbursement.

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Medisys Compliance

APRIL 11, 2024

Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) can now directly bill Medicare for services they furnish and diagnose. Eligibility and Covered Services To directly bill Medicare, you must meet specific eligibility criteria. The next step involves enrolling as a Medicare provider.

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Medisys Compliance

JANUARY 11, 2024

Audits: Increased scrutiny from Medicare and Medicaid for potential coding discrepancies. Documentation Burden Detailed documentation is crucial for supporting claims and ensuring compliance with regulations. Proper medical terminology and abbreviations. Missing out on reimbursement for newly covered services.

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Medisys Compliance

JULY 27, 2023

Medisys Data Solutions (MDS) understand the challenges that healthcare professionals face when it comes to medical billing and coding in Kentucky. The complex landscape of billing regulations, ever-evolving guidelines, and the need for compliance can be overwhelming. This helps maintain compliance and reduce errors.

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Medisys Compliance

JANUARY 21, 2024

Understanding the Bill and its Implications The mental health omnibus bill encompasses a multitude of provisions aimed at bolstering mental health resources and services. Mental Health Billing and the Mental Health Omnibus Bill These changes will undoubtedly affect billing practices.

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Medisys Compliance

OCTOBER 27, 2023

Optimizing these processes ensures timely and accurate billing, minimizes claim denials, and improves cash flow. Considering Outsourcing Options Outsourcing medical billing services is a viable option for small practices looking to reduce administrative burdens and improve efficiency.

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Medisys Compliance

MARCH 7, 2024

These changes reflect emerging procedures, innovative technologies, and revisions to existing medical practices. Healthcare professionals must familiarize themselves with these changes to avoid coding errors and ensure compliance with regulatory requirements.

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Medisys Compliance

FEBRUARY 21, 2024

Introduction As an obstetrician-gynecologist (OB/GYN) provider, accurate coding and billing are essential for ensuring proper reimbursement and maintaining compliance with healthcare regulations. However, improper use of this code can lead to billing errors and potential compliance issues.

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Medisys Compliance

APRIL 26, 2024

Outsource billing to a qualified medical billing service: Partnering with a medical billing company allows primary care practices to leverage experienced staff for coding, claim submission, and denial management.

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Medisys Compliance

DECEMBER 12, 2023

In this article, we will explore the most important behavioral health billing updates planned for 2024, focusing on both Medicare and commercial payers. Behavioral Health Billing Updates: For Medicare 1. We are your partner in success, committed to helping your behavioral health practice thrive.

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Medisys Compliance

APRIL 10, 2024

But navigating the complexities of HBOT billing can be daunting. This article equips US-based wound care providers with the knowledge to ensure proper reimbursement for this valuable service. Understanding Coverage and Coding Medicare reimbursement for HBOT hinges on the diagnosis.

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Medisys Compliance

APRIL 1, 2024

Maximizing Reimbursement for Telehealth Services Stay Informed: Keep yourself updated on the latest telehealth billing regulations from Medicare, Medicaid, and private insurers. Choose the Right Codes: Select the most accurate E/M and HCPCS codes reflecting the complexity of the telehealth service provided.

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Medisys Compliance

APRIL 23, 2024

Stay Current on Regulations and Coding Updates Monitor Regulatory Changes: Stay informed about updates to regulations like MACRA (Medicare Access and CHIP Reauthorization Act) that may impact your billing practices. Utilize resources from the Centers for Medicare & Medicaid Services (CMS) and your local healthcare associations.

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