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.

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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. In this article, we discussed about what is MAC and activities handled by all these contractors.

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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. If you are a healthcare provider or a medical biller, understanding the billing frequency for G0108 is crucial to ensure proper reimbursement and optimal utilization of this service.

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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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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.

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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.

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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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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?

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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.

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Medisys Compliance

APRIL 10, 2024

But navigating the complexities of HBOT billing can be daunting. This article equips US-based wound care providers with the knowledge to ensure proper reimbursement for this valuable service. Understanding Coverage and Coding Medicare reimbursement for HBOT hinges on the diagnosis.

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Medisys Compliance

FEBRUARY 27, 2024

Introduction Radiology billing compliance is a critical aspect of managing a successful radiology practice. With a myriad of regulations and the potential for audits looming, radiologists and billing staff need to have a solid understanding of compliance requirements.

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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.

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Medisys Compliance

NOVEMBER 26, 2024

Skilled Nursing Facility (SNF) billing compliance is a critical aspect of healthcare revenue cycle management, ensuring accurate reimbursement and adherence to Medicare regulations. As healthcare providers navigate the complexities of SNF billing, maintaining compliance is essential to avoid penalties, denials, and financial losses.

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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.

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Medisys Compliance

MAY 20, 2024

This article dives into the world of mental health services reimbursement rates, empowering providers with knowledge to navigate this complex system. Payer type: Private insurance companies, Medicare, and Medicaid have their own reimbursement structures. What are Reimbursement Rates?

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Medisys Compliance

JULY 17, 2024

Introduction In the ever-evolving field of oncology, staying abreast of the latest coding guidelines is crucial for accurate billing and reimbursement. This article explores into the new coding guidelines for chemotherapy administration, a cornerstone procedure in oncology. All rights reserved.

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Medisys Compliance

APRIL 15, 2024

This article explores some of the key changes in urology CPT codes for 2024, empowering you to navigate the billing landscape with confidence. Reference: American Urological Association (AUA) Coding and Reimbursement section CPT® codes and descriptions are copyrighted by the American Medical Association (AMA).

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Medisys Compliance

DECEMBER 10, 2024

Spine surgery billing is a critical component of revenue cycle management for practices specializing in neurosurgery and orthopedics. With detailed procedures, evolving payer guidelines, and highly specific CPT codes, accurate billing ensures optimal reimbursement and compliance. Missing this step can lead to denial.

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Medisys Compliance

APRIL 22, 2022

In the Medicare Physician Fee Schedule final rule issued in November 2021, the Centers for Medicare and Medicaid Services (CMS) added four new CPT codes (99424, 99425, 99426, and 99427) in the category of Principal Care Management (PCM) to replace the two previous PCM codes (HCPCS codes G2064 and G2065).

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Medisys Compliance

APRIL 30, 2024

However, navigating the specific billing practices for telehealth anesthesia services can be complex. This article provides a comprehensive guide for anesthesiologists and providers on telehealth anesthesia billing, covering key aspects of telehealth billing. Medicare, private insurance).

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Medisys Compliance

JANUARY 29, 2024

This article tackles this very challenge, equipping you, the dedicated healthcare professional, with the knowledge and resources to navigate the world of code with confidence. Subscribe to coding updates: The American Medical Association regularly updates CPT codes. Stay informed through their website or professional organizations.

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Medisys Compliance

APRIL 1, 2024

However, navigating the billing process for these virtual visits can be complex for primary care providers. This article act as a comprehensive guide to understand and excel telehealth billing for your practice. Policies can change frequently.

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Medisys Compliance

FEBRUARY 29, 2024

However, navigating the small details of billing for these services can be challenging. This article explores into the key considerations for optimizing billing for virtual care in primary care, ensuring you receive proper reimbursement for your services. secure messaging).

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Medisys Compliance

AUGUST 6, 2024

Navigating the complexities of internal medicine billing can be especially challenging for small practices. Limited resources, frequent updates in billing regulations, and the need for precise coding make it difficult to manage billing in-house. Here’s why specialized billing services are crucial: 1.

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Medisys Compliance

JULY 31, 2024

Key considerations include: Medicare: Medicare has established specific coverage criteria for various immunotherapies. References Links: American Medical Association – CPT Codes Article – Billing and Coding: Allergy Immunotherapy (A57472) CPT® Copyright 2024 American Medical Association.

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Medisys Compliance

MARCH 15, 2024

This article, brought to you by Medisys , a leading medical billing company, explores RIAS coding specific to urology practices. Introduction Accurate and efficient coding is crucial for urology practices to ensure proper reimbursement and financial stability. What is RIAS?

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Medisys Compliance

FEBRUARY 26, 2024

In this article, we’ll explore the concept of bundled payments and episode based billing in cardiology care, their implications for providers, and strategies for success in this evolving reimbursement paradigm.

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Medisys Compliance

JULY 16, 2024

Introduction Mental health billing can be a complex and daunting task for healthcare providers. This article aims to provide a detailed overview of mental health billing solutions, helping providers streamline their billing processes and improve their revenue cycle management. Recent changes include: 1.

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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. Medicare won’t cover over-the-counter COVID-19 tests for Medicare Part A (Hospital Insurance) coverage, but beneficiary may be able to get free tests through other programs.

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Medisys Compliance

MARCH 14, 2023

In this article, we shared wound care reimbursements in certain healthcare facilities. 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.

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Medisys Compliance

DECEMBER 12, 2023

As we move into 2024, several key updates will impact how behavioral health providers bill for their services. In this article, we will explore the most important behavioral health billing updates planned for 2024, focusing on both Medicare and commercial payers. Behavioral Health Billing Updates: For Medicare 1.

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Medisys Compliance

AUGUST 8, 2022

In this article, we shared billing guidelines for anesthesia payment at personally performed rate and calculation of anesthesia time units. We referred Medicare billing guidelines from Medicare claims processing manual chapter 12.50 Reference: Medicare Claims Processing Manual Chapter 12.

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Medisys Compliance

FEBRUARY 21, 2024

However, improper use of this code can lead to billing errors and potential compliance issues. This article aims to provide OB/GYN providers with a comprehensive understanding of CPT code 59400 and strategies to avoid common billing pitfalls associated with its usage.

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Medisys Compliance

DECEMBER 29, 2023

This article serves as a detailed guide, unpacking the details of this CPT code range 92920-93793 and its applications within cardiology billing. CPT® is a registered trademark of the American Medical Association.

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Medisys Compliance

FEBRUARY 13, 2024

References: Psychotherapy codes for psychologists – APA Services CPT® 90837, Under Psychotherapy Services and Procedures *This article uses Current Procedural Terminology (CPT) codes, copyright 2024 by the American Medical Association. CPT is a registered trademark of the American Medical Association. All rights reserved.

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Medisys Compliance

AUGUST 1, 2024

Accurate and compliant group therapy billing requires a comprehensive understanding of patient eligibility, group composition, session structure, provider qualifications, and meticulous documentation. This article does not substitute for professional advice.

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Medisys Compliance

JULY 18, 2022

In the Balanced Budget Act of 1997, Congress mandated that payment for the majority of services provided to beneficiaries in a Medicare covered SNF stay be included in a bundled prospective payment made through the Part A Medicare Administrative Contractor (MAC) to the SNF. This practice created several problems. To summarize.

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