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 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.

Medicare 52

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

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

APRIL 8, 2022

In this article, we briefly discussed these Medicare telehealth billing guidelines. CMS has finalized certain services added to the Medicare telehealth services list will remain on the list through December 31, 2023.This To know more about our Telehealth billing services, contact us at info@medisysdata.com/ 302-261-9187.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

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).

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

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.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

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 13, 2023

Medicare recognizes the importance of diabetes self-management training and offers coverage for eligible beneficiaries. However, there are specific guidelines and conditions that need to be met for Medicare billing. Diabetes Education Billing Guidelines for Medicare Who May Furnish the Training?

Medicare 52

Medicare Medicare Medical Billing Outsourcing Health Outcomes 52

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

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. Activities done by MACs.

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

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. Eligible providers.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 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 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

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.

Medicare 52

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

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 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. Medicare Coverage. Only a qualified home infusion therapy supplier can bill for services under the new home infusion therapy services benefit.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

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.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

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

APRIL 10, 2024

But navigating the complexities of HBOT billing can be daunting. Understanding Coverage and Coding Medicare reimbursement for HBOT hinges on the diagnosis. You’ll need to establish medical necessity by linking the therapy to the specific diagnosis and demonstrating that conventional therapies have failed.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 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. Documentation Requirements Accurate and thorough documentation is essential for radiology billing compliance.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 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

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

MAY 20, 2024

Payer type: Private insurance companies, Medicare, and Medicaid have their own reimbursement structures. Payer Websites: Insurance companies and government agencies (Medicare, Medicaid) often publish reimbursement rates on their websites.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

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.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare 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

AUGUST 6, 2024

Unlike larger practices, small practices often lack the resources to maintain a dedicated billing department, leading to potential errors and delays in reimbursement. Here’s why specialized billing services are crucial: 1. Claims Management Efficient and timely submission of claims to insurance companies and Medicare.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Patient Satisfaction Medical Billing Compliance 59

Medisys Compliance

SEPTEMBER 29, 2022

Your medical billing outsourcing partner takes care of the same in a hassle-free manner. ICD-10, CPT, and HCPCS coding certification training for medical billing and coding software. Understanding of insurance policy rules, particularly those relating to Medicare. Wrapping up. What are you waiting for?

Medical Billing Outsourcing 98

Medical Billing Outsourcing Medical Billing Medicare Medicare 98

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

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 Medical Billing Medicaid Medicaid 59

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

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 Medical Billing Medicaid Medicaid 59

Medisys Compliance

JULY 16, 2024

Recent Changes in Mental Health Billing The landscape of mental health billing is continuously evolving. Medicare Updates Medicare has expanded its coverage for mental health services, including telehealth. Stay updated with the latest Medicare guidelines to ensure compliance and optimize reimbursements.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 59

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). Use Specific Codes: Avoid using unspecified or generalized codes.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Compliance 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

AUGUST 23, 2024

The compliance process involves understanding and following payer-specific guidelines, particularly those set by Medicare. Example: Medicare’s guidelines for oncology coding are detailed and specific. Example: Medicare guidelines often change, particularly regarding how certain treatments like radiation therapy should be coded.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59