Medisys Compliance

JANUARY 23, 2025

As we step into 2025, mental health providers must stay informed about evolving telehealth billing regulations to ensure compliance and optimize reimbursement. Will Medicare Stop Paying for Telehealth in 2025? Will Medicare Stop Paying for Telehealth in 2025? What Is the CPT Code for Telehealth in 2025?

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Medical Billing 59

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. Reduced the eligibility criteria for the reading radiologist.

Medicare 97

Medicare Medicare Medical Billing Medical Billing Outsourcing 97

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

MARCH 19, 2025

ICD-10 codes, on the other hand, establish the medical necessity for these procedures, indicating the patient’s diagnosis or the reason for the radiological examination. For instance, a specific ICD-10 code might be required to demonstrate the medical necessity for an advanced imaging study like a PET scan.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

Medisys Compliance

MAY 23, 2024

Introduction The Centers for Medicare & Medicaid Services (CMS) establish specific billing guidelines for behavioral health services provided to Medicare beneficiaries. This article provides a comprehensive overview of essential information for providers navigating CMS behavioral health billing guidelines.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

Medisys Compliance

DECEMBER 30, 2024

Medicare: Pays based on the Medicare Physician Fee Schedule (e.g., $85$130 Billing for Cognitive Behavioral Therapy for Insomnia CBT for Insomnia (CBT-I) is a specialized form of therapy that has gained traction. Q2: Can I bill for CBT and E/M services on the same day? 85$130 for psychotherapy codes).

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59

Medisys Compliance

JANUARY 31, 2024

Introduction Understanding the details of Medicare coding and claims submission can be daunting for anyone. While accurate billing ensures fair reimbursement and uninterrupted patient care, billing mistakes can have significant consequences, leading to financial losses, claim denials, and even penalties.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

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.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

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.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 59

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.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 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.

Overpayments 52

Overpayments Overpayment Medicare Medicare 52

Medisys Compliance

JULY 19, 2024

Introduction The landscape of Medicare and Medicaid billing for behavioral health services has undergone significant changes recently. This article discusses the latest changes, providing a comprehensive guide to navigating the evolving billing landscape.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

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.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

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].

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 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

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.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

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.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Medisys Compliance

DECEMBER 29, 2022

In addition to speeding up the bill-paying procedure, the digital payment option is regarded as being more secure. To guarantee that your staff has access to training on requirements for Medicare, and significant private insurers, educate staff on payer-specific policies. The post How To Reduce AR Days With Oncology Billing?

Medical Billing 98

Medical Billing Medical Billing Outsourcing Medical Billing Services Doctors 98

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

JANUARY 30, 2025

Pre-Authorization: Required for high-cost or complex procedures, ensuring payer approval before the service is provided. Essential Details to Collect When verifying insurance for radiology services, its critical to gather accurate and specific information: Policy Status: Confirm active coverage for the date of service.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Patient Satisfaction 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

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

SEPTEMBER 16, 2022

Particularly, a dermatology modifier provides the mechanism to: Report or indicate that a service or procedure was performed and changed as a result of a specific circumstance without changing the meaning of the CPT code. Provide information that is not included in the code descriptor. Basic Understanding of Modifier 50.

Medical Billing 105

Medical Billing Medical Billing Outsourcing Medicare Medicare 105

Medisys Compliance

FEBRUARY 10, 2025

Stay informed about payer policies to avoid claim denials. 2025 Update: With enhanced documentation requirements, 90832 now includes a telehealth modifier (if applicable), ensuring that whether the session is in-person or remote, the service is accurately captured and reimbursed.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medical Billing Services 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

FEBRUARY 18, 2025

Communicate changes to patients: If reimbursement changes impact what services you can offer via telehealth, youd need to clearly communicate these changes to your patients. Audio-Only (Phone) Sessions During the public health emergency, many payers, including Medicare, expanded coverage to include audio-only telehealth for behavioral health.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Licensing Medical Billing Patient Satisfaction 59

Medisys Compliance

FEBRUARY 16, 2025

Programs like MIPS (Merit-based Incentive Payment System), APMs (Advanced Alternative Payment Models), HEDIS (Healthcare Effectiveness Data and Information Set), and MACRA (Medicare Access and CHIP Reauthorization Act), each with specific metrics and reporting requirements, directly impact billing and reimbursements.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Patient Satisfaction Payment Systems 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

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

SEPTEMBER 29, 2022

Let’s glance through scores of reasons as to why denial management services are required for optometrists, shall we? Verification and eligibility of the patient: From collecting adequate information, verification to checking eligibility of the patients, medical billing companies play a significant role. Wrapping up.

Medical Billing Outsourcing 98

Medical Billing Outsourcing Medical Billing Medicare Medicare 98

Medisys Compliance

APRIL 14, 2022

The Advance Beneficiary Notice of Noncoverage (ABN) i.e., form CMS-R-131, is issued by providers (including independent laboratories, home health agencies, and hospices), physicians, practitioners, and suppliers to Original Medicare (fee for service – FFS) beneficiaries in situations where Medicare payment is expected to be denied.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

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.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

Healthcare IT Today

JUNE 29, 2023

However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. Medicare Certification ASCs must sign a contract with Medicare and meet its Conditions for Coverage (CFC) to be paid. ASCs must also meet Medicare’s Conditions for Coverage.

Compliance 52

Compliance Medicare Medicare Medical Billing 52

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

AUGUST 4, 2022

The Centers for Medicare & Medicaid Services (CMS) on June 21, 2022, issued a proposed rule that proposes to update payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2023.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

Medisys Compliance

APRIL 17, 2025

Advanced Imaging Billing Challenges Radiology billing teams face several unique hurdles when it comes to advanced imaging procedures: Prior Authorization Delays: Many payers, especially Medicare Advantage plans and commercial insurers, require pre-authorization through Radiology Benefit Managers (RBMs) like eviCore or AIM.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59