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.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

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. For detailed understanding we shared observations of OIG where they found that some of the claims were wrongly denied by private Medicare plans.

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Medicare Medicare US Department of Health and Human Services Medical Billing Outsourcing 52

Medisys Compliance

FEBRUARY 27, 2024

Key regulations include the Health Insurance Portability and Accountability Act (HIPAA), the Stark Law, the Anti-Kickback Statute, and regulations set forth by the Centers for Medicare & Medicaid Services (CMS) and private payers. Documentation Requirements Accurate and thorough documentation is essential for radiology billing compliance.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

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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Overpayments Overpayment Medicare Medicare 52

Medisys Compliance

APRIL 11, 2022

Billing for Ambulatory Surgery Centers (ASCs) is tightly regulated by numerous federal as well as state-level regulatory authorities. Complete documentation will support all procedure codes your billed and will provide complete picture for payers. Pre-operative medical record documentation. Discharge documentation.

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Medisys Compliance

MAY 17, 2024

Medical Necessity: Payers may deny claims if they deem the service not medically necessary. This often involves providing clear documentation justifying the treatment plan. Missing or Incomplete Information: Claims with missing documentation or unclear notes may be denied for further review.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 59

Medisys Compliance

APRIL 30, 2024

This article provides a comprehensive guide for anesthesiologists and providers on telehealth anesthesia billing, covering key aspects of telehealth billing. Eligible Services for Telehealth Billing The Centers for Medicare & Medicaid Services (CMS) maintains a list of services eligible for telehealth billing.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Informed Consent 59

Medisys Compliance

JULY 29, 2022

We are sharing Medicare guidelines for laser-assisted cataract surgery billing from a last updated CMS document. We shared this document as it was published, to avoid any error while billing for laser-assisted cataract surgery. Medicare Policy Regarding Non-Covered Services.

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Medicare Medicare Medical Billing Medical Billing Outsourcing 52

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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Medical Billing Outsourcing Medical Billing Medicare Medicare 59

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.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Medisys Compliance

APRIL 5, 2024

Some common modifiers used in MPI billing include: 59 (Distinct procedural service): Used if a separate and medically necessary service is performed on the same day as the MPI (e.g., Medicare Coverage and Reimbursement MPI is covered by Medicare under specific conditions.

Medical Billing 64

Medical Billing Medical Billing Outsourcing Medicare Medicare 64

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. Efficient documentation practices and record-keeping systems.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

FEBRUARY 19, 2024

Diagnosis Drives Reimbursement: Accurately document diagnoses using ICD-10 codes that align with the group’s focus and individual client needs. Ensure diagnoses support the medical necessity of group therapy for each participant. If you treat Medicare or Medicaid patients, ensure you have the necessary knowledge and resources.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

APRIL 23, 2024

Implement Regular Audits: Regularly audit your billing processes to identify and address any coding inconsistencies or documentation gaps. missing information, coding errors) and have a clear process for appealing denials with proper documentation. This fosters trust and reduces billing surprises.

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Medical Billing Medical Billing Outsourcing Medicare Medicare 59

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. In this article, we shared coding guidelines and Medicare coverage for Chiropractic Manipulative Treatment (CMT).

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Medicare Medicare Medical Billing Medical Billing Outsourcing 59

Medisys Compliance

NOVEMBER 21, 2023

Accurate and timely billing is a fundamental aspect of financial success for Skilled Nursing Facilities (SNFs), particularly when it comes to optimizing SNF billing. In this guide, we will explore into essential SNF billing tips to help you optimize your billing processes and navigate the complexities of reimbursement.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Medical Billing 59

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 also waives the AWV coinsurance or co-payment and the Medicare Part B deductible.

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Medicare Medicare Medical Billing Outsourcing Medical Billing 52

Medisys Compliance

FEBRUARY 29, 2024

This article explores into the key considerations for optimizing billing for virtual care in primary care, ensuring you receive proper reimbursement for your services. Understanding Virtual Care Billing Codes Familiarizing yourself with the specific billing codes assigned by Medicare and private payers is paramount.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Informed Consent Medical Billing Medicare 59

Medisys Compliance

MARCH 15, 2024

For proper reimbursement, ensure your medical records clearly document the specific hormone or substance measured in the RIA test. Also document the medical reason for ordering the RIA test, linking it to the patient’s diagnosis and treatment plan. Stay updated on coding changes: CPT codes are periodically revised.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

APRIL 1, 2024

Documentation Requirements: Maintain thorough documentation of the telehealth encounter, including the communication method (video, audio-only, etc.), Patient Consent: Ensure patients have consented to receiving telehealth services and understand potential billing implications. Stay updated on your state’s regulations.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing COVID-19 Medicaid 59

Medisys Compliance

FEBRUARY 21, 2024

Billing Components of CPT Code 59400 Antepartum Care: Antepartum care includes all prenatal visits and services provided to the pregnant patient before delivery. Each antepartum visit should be documented thoroughly, including the history, physical examination, medical decision-making, and any procedures or interventions performed.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicaid 59

Medisys Compliance

MAY 3, 2024

This guide will equip you with the knowledge to decipher these often-confusing documents. An EOB is a document sent by an insurance company to a patient after a healthcare service is rendered. Gather Supporting Documentation: If necessary, gather documentation to justify the service, such as treatment notes or progress reports.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

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. practitioner must obtain patient consent before furnishing or billing CCM.

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Medicare Medicare Medical Billing Outsourcing Medical Billing 52

Medisys Compliance

APRIL 22, 2024

Understanding Urology Billing The core principles of medical billing remain the same for urology. Documentation Thorough documentation is essential for accurate coding and claim acceptance. Claim Submission Similar to general billing, coded claims are submitted electronically to insurance companies.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicaid 59

Medisys Compliance

APRIL 16, 2024

While seemingly straightforward, complexities arise due to insurance regulations and documentation requirements. Ensure impeccable documentation reflects the exact start and end times, excluding administrative tasks. Medical Necessity: Justify why a 60-minute session is necessary.

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Medical Billing Outsourcing Medical Billing Compliance Medical Billing Services 59

Medisys Compliance

MARCH 7, 2024

Consequently, staying informed about these updates is imperative for healthcare professionals to accurately document and bill for services rendered. Similarly, revisions to existing codes may reflect updates in procedural techniques or changes in documentation requirements.

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Medical Billing Medical Billing Outsourcing Regulatory Compliance Compliance 59

Medisys Compliance

FEBRUARY 13, 2024

In progress notes, document session duration, interventions, and treatment plan goals. When family members are involved, utilize specific code modifiers (-96, -97) and submit detailed clinical documentation demonstrating medical necessity. Ensure informed consent is obtained for treatment and billing practices.

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Medical Billing Outsourcing Informed Consent Medical Billing Compliance 69

Medisys Compliance

APRIL 26, 2024

Essential Considerations for Accurate Outpatient Billing Accurate Documentation: Detailed and clear physician documentation is vital for accurate coding. Documentation should reflect the history of present illness, review of systems, medical decision-making, physical examination findings, and assessment/plan.

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Medical Billing Medical Billing Outsourcing Medical Billing Services Patient Satisfaction 59

Medisys Compliance

MARCH 10, 2024

However, billing for telehealth services involves navigating complex regulations and payer policies. Understanding the requirements for telehealth reimbursement and documenting services appropriately are crucial aspects of successful billing in this evolving landscape.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing COVID-19 Nurses 59

Medisys Compliance

SEPTEMBER 29, 2022

This is exactly wherein the professional optometry billing companies step into the picture to toss away complex and stressful tasks. When it comes to denial management for optometrists, these physicians face scores of challenges, some of them are as follows: Bad or missing documentation. Failure to have a proper financial policy.

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Medical Billing Outsourcing Medical Billing Medicare Medicare 98

Medisys Compliance

NOVEMBER 6, 2023

Introduction Orthopedic billing compliance is essential for healthcare providers to avoid costly audits and penalties. By following a comprehensive orthopedic billing compliance checklist, providers can ensure that their claims are accurate, complete, and supported by proper documentation.

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Compliance Medical Billing Outsourcing Medical Billing ACA 59

Medisys Compliance

JANUARY 4, 2024

Code selection hinges on the time spent, complexity of medical decision-making, and four key elements: history, examination, medical decision-making, and counseling/coordination of care. Required Documentation Solid medical documentation is your armor against denials and audits.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medical Billing Services 59

Medisys Compliance

DECEMBER 21, 2022

The problem is that not all forms of wound care are paid for by insurance, and those that are reimbursed require a number of administrative tasks like correct documentation, precise detailing, and accurate coding. The following are necessary for wound care billing and coding: It is necessary to give a thorough account of the injury.

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Medical Billing Medical Billing Outsourcing Medical Billing Services HIPAA 98

Medisys Compliance

DECEMBER 29, 2023

Introduction The realm of cardiology encompasses a vast array of specialized services and procedures, demanding precise documentation and accurate coding for proper reimbursement. This article serves as a detailed guide, unpacking the details of this CPT code range 92920-93793 and its applications within cardiology billing.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

FEBRUARY 26, 2024

With expertise in coding, documentation, and compliance, Medisys ensures accurate reimbursement for comprehensive cardiac services. Contact Medisys to learn more about cardiology billing services. Trust Medisys to optimize your revenue cycle management, allowing you to focus on delivering high-quality care to your patients.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Patient Satisfaction Medicaid 59

Medisys Compliance

JANUARY 29, 2024

Documentation is key: Clear and concise medical records with specific details support your chosen codes. Subscribe to coding updates: The American Medical Association regularly updates CPT codes. Highlight the importance of specifying the number of vessels accessed and the type of catheterization (left vs. right heart).

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Medical Billing Outsourcing Medical Billing Medicare Medicare 64

Medisys Compliance

FEBRUARY 14, 2024

Accurate ICD-10 coding ensures appropriate reimbursement and reflects the patient’s medical history. Accurately documenting the history, examination, and medical decision-making determines the appropriate E/M code (e.g., 99213) and subsequent physician compensation. Thorough code review is crucial.

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Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 52