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

AUGUST 1, 2023

However, navigating the complexities of medical billing can be a daunting task, diverting valuable time and resources away from patient care. This is where Medisys Data Solutions (MDS) steps in, offering comprehensive medical billing services in North Carolina tailored to the unique needs of healthcare providers in NC.

Medical Billing Services 52

Medical Billing Services Medical Billing Medical Billing Outsourcing Compliance 52

Medisys Compliance

AUGUST 1, 2023

However, navigating the complexities of medical billing can be a daunting task, diverting valuable time and resources away from patient care. This is where Medisys Data Solutions (MDS) steps in, offering comprehensive medical billing services in North Carolina tailored to the unique needs of healthcare providers in NC.

Medical Billing Services 52

Medical Billing Services Medical Billing Medical Billing Outsourcing Compliance 52

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

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

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

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.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Medisys Compliance

MAY 19, 2022

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. 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.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 52

Medisys Compliance

APRIL 29, 2025

Helpful Resources for Cardiology Coders For continued education and compliance, cardiology billing teams should regularly consult: AMA CPT Resources: For official CPT code updates and guidelines. CMS (Centers for Medicare and Medicaid Services): For NCCI edits and Medicare coding policies.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicare 59

Medisys Compliance

APRIL 19, 2023

The Medicaid program in Florida provides medical services and assistance to low-income individuals and families. To participate in the Medicaid program, healthcare providers must meet several general requirements set forth by the Agency for Health Care Administration (AHCA).

Medicaid 52

Medicaid Medicaid Medical Billing Outsourcing Licensing 52

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.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

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.

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

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

FEBRUARY 24, 2025

Understanding modifier application can optimize your group therapy billing. Reimbursement rates for CPT code 90853 in group therapy billing vary significantly. Factors influencing reimbursement include the payer type ( Medicare , Medicaid, commercial insurance), geographic location, and specific contract agreements.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 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. Medisys: A Reliable Medical Billing Service Provider Don’t let billing paperwork slow you down!

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

Medisys Compliance

APRIL 8, 2025

Ensure they are familiar with CPT codes for psychotherapy , evaluations, and medication management. Experience with Insurance Companies and Credentialing: A reliable billing partner should have experience working with Medicare, Medicaid, and commercial insurance payers.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Compliance HIPAA 59

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.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

Medisys Compliance

MARCH 12, 2025

Cardiology practices frequently interact with a diverse landscape of payers – from Medicare and Medicaid to a multitude of commercial insurance companies. Navigating Payer-Specific Submission Protocols In cardiology claim processing, a one-size-fits-all approach to claim submission simply doesn’t work.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 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.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicaid 59

Medisys Compliance

MAY 22, 2024

Partnership with a Medical Billing Service Consider partnering with a medical billing service like Medisys to streamline your billing process. Appealing Denied Claims: If a claim is denied, review the Explanation of Benefits (EOB) to understand the reason.

Compliance 59

Compliance Medical Billing Services Medical Billing Medical Billing Outsourcing 59

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

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. Trust Medisys for comprehensive radiology billing services tailored to your needs.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 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

AUGUST 27, 2024

Here are some best practices: Stay Updated: CPT codes and billing guidelines are subject to change. Regularly review updates from authoritative sources like the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS).

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Compliance 59

Medisys Compliance

APRIL 18, 2022

In October 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced a goal of having every Medicare beneficiary and the majority of Medicaid beneficiaries covered by some type of alternative payment model (APM) by 2030. In order to do so, a clinician must be in a Medicare Advanced APM.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicaid Medicaid 52

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.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 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

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. Missing out on reimbursement for newly covered services.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medicaid Medical Billing 59

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. Reimbursement is based on contract agreements and fee schedules.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Telemedicine 59

Medisys Compliance

APRIL 20, 2022

We shared billing update for free COVID-19 tests and second free booster dose in detail in this article. Medicare to Cover Over-the-Counter COVID-19 Tests. People with Medicare can get up to eight tests per calendar month from participating pharmacies and health care providers for the duration of the COVID-19 public health emergency.

COVID-19 52

COVID-19 COVID-19 Vaccine Medical Billing Medicare 52

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.

Medical Billing 59

Medical Billing Medical Billing Services Medical Billing Outsourcing Medicaid 59

Medisys Compliance

MARCH 14, 2023

DRGs are a payment classification system used by Medicare and other insurance providers to categorize patients into groups based on their diagnosis, severity of illness, and the resources required for their care. Wound care services are reimbursed based on the patient’s diagnosis and the complexity of the wound.

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52

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. This helps maintain compliance and reduce errors.

Medical Billing 52

Medical Billing Telemedicine Medicaid Medicaid 52

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

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.

Medical Billing Outsourcing 105

Medical Billing Outsourcing Medical Billing Compliance Governance 105

Medisys Compliance

JUNE 28, 2022

Medicare Coverage for Continuous Glucose Monitors (CGMs). On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule in the Federal Register that addressed the classification and payment of continuous glucose monitors (CGMs) under the Medicare Part B benefit for durable medical equipment (DME).

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Medicare Medicare 52