Medisys Compliance

MARCH 19, 2025

Understanding each payer’s individual policies regarding CPT and ICD-10 coding, including their specific medical necessity requirements, is vital. Staying informed about payer-specific bulletins and updates is crucial for avoiding denials. In radiology billing, certain modifiers are particularly essential.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

Medisys Compliance

FEBRUARY 24, 2025

For billing purposes, group therapy generally refers to structured psychotherapy sessions conducted with multiple patients simultaneously, under the direction of a qualified mental health professional. Understanding modifier application can optimize your group therapy billing. This is fundamental information for group therapy billing.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 59

Medisys Compliance

MARCH 12, 2025

Accuracy in patient demographics, verified insurance information, and precise referring physician details (often vital for cardiology referrals) forms the bedrock of successful cardiology claim processing. This is the point of claim generation, and ensuring data integrity here is paramount.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 59

Medisys Compliance

JANUARY 16, 2025

Behavioral health providers play a critical role in addressing mental health challenges, but navigating the complexities of billing can be daunting. The Centers for Medicare & Medicaid Services (CMS) provides comprehensive behavioral health billing guidelines, which can be overwhelming due to their technical nature and breadth.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Fraud 59

Medisys Compliance

MAY 20, 2024

Payer type: Private insurance companies, Medicare, and Medicaid have their own reimbursement structures. Factors Affecting Reimbursement Rates Several factors influence reimbursement rates: CPT Codes: Current Procedural Terminology (CPT) codes categorize specific services. Stay Informed: Reimbursement rates can change periodically.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

Medisys Compliance

APRIL 29, 2025

Acute myocardial infarction, unspecified These diagnosis codes support medical necessity for procedures and determine the level of service billed. Modifiers clarify circumstances that altered the service or procedure, such as: Indicating that multiple procedures were performed during the same encounter.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicare 59

Medisys Compliance

MARCH 24, 2025

Unlike traditional primary care, urgent care centers handle a mix of walk-in patients with varying levels of acuity, which creates a complex billing environment. Efficient billing ensures your urgent care facility gets reimbursed accurately and promptly. Contact us today to streamline your billing process and boost profitability!

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicaid 59

Medisys Compliance

MARCH 18, 2025

H2019) for Medicaid behavioral health programs; and ICD-10 codes for mental health diagnoses (F-codes). We ensure correct modifiers are used, such as modifier -25 when billing an E/M service with psychotherapy or modifier GT or 95 for telehealth services.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medical Billing HIPAA 59

Medisys Compliance

OCTOBER 27, 2023

Verifying Insurance Coverage One common pitfall that practices encounter is failing to verify patient insurance coverage and eligibility before providing services. This can result in claim rejections due to incorrect insurance information. Specialized medical billing companies have the expertise to handle billing tasks efficiently.

Medical Billing 59

Medical Billing Medical Billing Services Medical Billing Outsourcing Medicaid 59

Medisys Compliance

MAY 17, 2024

Eligibility Issues: Patient insurance coverage may be inactive, lack specific benefits, or require prior authorization for certain services. Missing or Incomplete Information: Claims with missing documentation or unclear notes may be denied for further review. Act promptly to avoid missing deadlines.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 59

Medisys Compliance

AUGUST 11, 2024

As a leading provider of medical billing services, we understand the difficulties and challenges faced by therapists in managing their billing processes. Accurate and efficient billing is crucial for maintaining a stable cash flow and ensuring that therapists are reimbursed for their services.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Services Medical Billing Regulatory Compliance 52

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. CMS Announcement for Revised Coverage. Receive a written order for lung cancer screening with LDCT.

Medicare 97

Medicare Medicare Medical Billing Medical Billing Outsourcing 97

Medisys Compliance

DECEMBER 23, 2022

The finalized 2023 Medicare Physician Fee Schedule was announced by the Centers for Medicare & Medicaid Services (CMS) on November 1 2022. As a result, adjustments to the PFS over time may cause a physician’s final payment for the same service to change.

Medicare 98

Medicare Medicare Medical Billing Medical Billing Outsourcing 98

Medisys Compliance

MAY 15, 2024

Additionally, self-service portals that allow patients to access invoices and track their claims easily can improve the overall billing experience. Staying Ahead of the Curve The future of mental health billing is evolving rapidly.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Services Medical Billing Medicaid 59

Medisys Compliance

JANUARY 9, 2024

Stay informed and implement them promptly to avoid denials. By putting these tips into action, small healthcare providers can overcome the challenges of medical billing and achieve claim acceptance rates that rival larger organizations. Stay compliant with regulations: Healthcare regulations change frequently.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicaid 59

Medisys Compliance

APRIL 8, 2024

Strategies to Accelerate Medical Billing and Enhance Cash Flow Accuracy at the Forefront Clean Patient Demographics: Ensure accurate and up-to-date patient information like name, address, insurance details, and date of birth during check-in. Incorrect information can lead to claim rejections and delays.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Patient Satisfaction 59

Medisys Compliance

FEBRUARY 19, 2024

Additional Considerations In-network vs. out-of-network billing: Understand the differences in reimbursement rates, patient responsibility, and billing procedures for in-network and out-of-network claims. Medicare and Medicaid billing: These programs have specific regulations and coding requirements for group therapy billing.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medicaid Medical Billing 59

Medisys Compliance

JULY 27, 2023

How do I ensure compliance with Kentucky Medicaid and Medicare billing guidelines? Training and education: Ensure that the billing and coding staff receive appropriate training on Kentucky Medicaid and Medicare guidelines. Documentation accuracy: Accurate and complete documentation is vital for billing compliance.

Medical Billing 52

Medical Billing Telemedicine Medicaid Medicaid 52

Medisys Compliance

APRIL 23, 2024

missing information, coding errors) and have a clear process for appealing denials with proper documentation. Strengthen Patient Communication and Collections Enhance Transparency: Provide patients with clear estimates of their out-of-pocket costs before services are rendered. Understand the reason for each denial (e.g.,

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

APRIL 25, 2024

MIPS focuses on four key performance categories: Quality: This measures the quality of care you provide to your patients based on specific metrics established by the Centers for Medicare & Medicaid Services (CMS). Reporting accurate data for cardiology-specific quality measures is crucial. MACRA regulations are subject to change.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

Medisys Compliance

MAY 27, 2024

99213, 99214) Healthcare Common Procedure Coding System (HCPCS) Codes: These codes may apply for additional services like pathology analysis or stent placement. Place of Service Codes: Indicate where the service occurred (e.g., Modifiers: These refine the information about the service provided (e.g.,

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Hospitals 59

Medisys Compliance

NOVEMBER 8, 2023

Introduction In recent years, the healthcare landscape has witnessed a significant shift towards telehealth services, and the field of mental health is no exception. This article will serve as a comprehensive guide to mental health telehealth billing, addressing the key aspects, regulations, and best practices for mental health providers.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medicaid Medical Billing 59

Medisys Compliance

OCTOBER 18, 2023

This diagnostic test records the electrical activity of the heart and provides valuable information about its function and any potential abnormalities. The interpretation and report of the EKG is an integral part of cardiovascular diagnostics, helping healthcare providers make informed decisions regarding patient care.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicaid Medicaid 59

Medisys Compliance

AUGUST 21, 2024

In 2024, the Centers for Medicare & Medicaid Services (CMS) introduced several crucial updates to radiation oncology billing guidelines. These changes affect coding, reimbursement, and compliance requirements, making it essential for providers to stay informed to maximize reimbursement and avoid penalties.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medicaid Medicaid 59

Medisys Compliance

JANUARY 11, 2024

Audits: Increased scrutiny from Medicare and Medicaid for potential coding discrepancies. Proper medical terminology and abbreviations. Regulatory Landscape Medicare and Medicaid regulations change frequently, demanding constant adaptation. Failure to keep up can result in: Incorrect billing practices lead to denials and audits.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medicaid Medical Billing 59

Medisys Compliance

FEBRUARY 13, 2025

Cardiology Modifiers Often, CPT and ICD-10 codes alone are insufficient to fully describe a service. Modifiers are two-digit codes appended to CPT or HCPCS codes to provide additional information without changing the code’s basic definition. This is where modifiers come in. Carefully evaluate the cost-benefit ratio.

Medical Billing 59

Medical Billing Medical Billing Services Medical Billing Outsourcing Medicaid 59

Medisys Compliance

MAY 2, 2024

Wound care providers can stay informed by: Following industry publications and attending relevant conferences. Keeping Your Focus on Healing: Partnering with Medisys Chronic wound care requires a high level of expertise, and navigating the complexities of billing shouldn’t add to your burden.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Services Medical Billing Patient Satisfaction 59

Medisys Compliance

AUGUST 20, 2024

With the growing demand for mental health services, providers must understand the complexities of behavioral health billing to ensure timely reimbursements, minimize denials, and maintain financial stability. These guidelines cover everything from who can bill for services to the required documentation and coding practices.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Licensing Medical Billing Informed Consent 59

Medisys Compliance

APRIL 1, 2024

Patient Consent: Ensure patients have consented to receiving telehealth services and understand potential billing implications. Maximizing Reimbursement for Telehealth Services Stay Informed: Keep yourself updated on the latest telehealth billing regulations from Medicare, Medicaid, and private insurers.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing COVID-19 Medicaid 59

Medisys Compliance

JULY 11, 2022

The prohibitions on balance billing and cost-sharing protections vary among providers depending on the type of services they furnish and their practice settings. Plans and issuers and providers and facilities must implement certain measures to improve the accuracy of provider directory information.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Health Insurance Medicaid 52

Medisys Compliance

APRIL 11, 2024

Familiarizing yourself with current telehealth billing guidelines established by CMS is essential to ensure proper reimbursement. Getting Started and Resources Available Several valuable resources can help you navigate the transition to direct billing. Subscribing to CMS updates can ensure you remain current on any modifications.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

Medisys Compliance

JUNE 22, 2022

Centers for Medicare & Medicaid Services (CMS) is discontinuing Certificates of Medical Necessity (CMNs) and DME Information Forms (DIFs) effective January 1, 2023. Originally, CMS required the CMN and DIF forms to help document medical necessity and other coverage criteria for selected DME.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicare Medicare 52

Medisys Compliance

AUGUST 1, 2024

cognitive-behavioral, psychodynamic), and the patients’ diagnoses should be taken into account to ensure the chosen code accurately reflects the services delivered. Modifier Usage Modifiers are alphanumeric codes added to CPT codes to provide additional information about the service performed.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medical Billing Regulatory Compliance 59

Medisys Compliance

JULY 23, 2024

Verify Coding Updates: Regularly review updates from the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) to stay current with coding changes. Implement these changes promptly to avoid billing errors and potential audits.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Informed Consent Medical Billing 59

Medisys Compliance

JANUARY 30, 2023

HIPAA: The Health Insurance Portability and Accountability Act( HIPAA) is a federal law that establishes the national standards for protecting the privacy and security of individuals’ personal health information ( PHI). Data Security: Data security is an increasingly important compliance issue for the medical billing industry.

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing Telemedicine 52

Medisys Compliance

FEBRUARY 9, 2024

Staying informed about new and revised CPT codes is essential for accurate coding and billing of wound care services. Providers should consult the latest CPT manual and coding resources to ensure they are using the correct codes for their services. Feeling overwhelmed by the latest wound care billing updates?

Medical Billing Outsourcing 59

Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

Medisys Compliance

JULY 31, 2024

Medicaid: Coverage and reimbursement policies differ by state. Avoiding Common Billing Errors Preventing billing errors is critical to ensuring timely and accurate reimbursement. Staying Updated with Regulatory Changes The landscape of immunotherapy billing is constantly evolving.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59