Medisys Compliance

NOVEMBER 27, 2024

Medicare covers certain podiatry services, but billing for them requires strict adherence to guidelines to ensure compliance and maximize reimbursement. What Does Medicare Cover for Podiatry Services? Routine Foot Care Exceptions: Medicare covers routine foot care (e.g., nontraumatic amputation of a foot).

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Medisys Compliance

JULY 15, 2024

Introduction As an internal medicine practitioner, staying updated with the latest Medicare billing changes is crucial for maximizing reimbursements and ensuring compliance. In 2024, several significant updates have been introduced that directly impact the billing processes for internal medicine.

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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. This article covers the essentials of SNF billing compliance, including processes, guidelines, exclusions, and practical tips for providers.

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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.

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Medisys Compliance

JULY 19, 2024

Introduction The landscape of Medicare and Medicaid billing for behavioral health services has undergone significant changes recently. Understanding these updates is crucial for behavioral health providers to ensure compliance, maximize reimbursements, and continue delivering high-quality care.

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Medisys Compliance

DECEMBER 18, 2024

Managing patient billing inquiries and collections. Unlike general medical billing outsourcing, primary care billing requires a focus on routine services such as evaluation and management (E/M) codes, preventive care, vaccinations, and chronic care management. Can Outsourced Billing Handle Denials and Appeals?

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Medisys Compliance

APRIL 24, 2024

PHI includes any information that can be used to identify a patient and their health condition, such as Name; Address; Date of birth; Social Security number; Diagnosis; Treatment records; Medication history; and Mental health notes. Why is HIPAA Important for Behavioral Health? Many individuals with behavioral health conditions face stigma.

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Medisys Compliance

NOVEMBER 6, 2023

Introduction Orthopedic billing compliance is essential for healthcare providers to avoid costly audits and penalties. By following a comprehensive orthopedic billing compliance checklist, providers can ensure that their claims are accurate, complete, and supported by proper documentation.

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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.

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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.

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Medisys Compliance

MAY 22, 2024

Accurate and Efficient Billing: We ensure your claims are submitted accurately and promptly to maximize reimbursements. Reduced Administrative Burden: Free up your valuable time to focus on patient care by delegating billing tasks to our experts.

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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?

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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

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.

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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.

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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.

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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

DECEMBER 24, 2024

Medicare Reimbursement Medicare covers teletherapy under specific guidelines: Eligible Providers: Includes licensed clinical social workers (LCSWs), clinical psychologists, and other licensed professionals. Check state-specific Medicaid guidelines to ensure compliance. the patients location or the use of specific technology).

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Medisys Compliance

JANUARY 30, 2023

The medical billing industry is a complex and ever-changing field, and it is crucial for healthcare providers and billing companies to stay compliant with government regulations. Let us discuss the top compliance issues in the medical billing industry, shall we? companies operating internationally.

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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).

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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.

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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

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.

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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

DECEMBER 21, 2022

You can get complete relief from time-consuming procedures with the aid of skilled billers and coders from wound care medical billing outsourcing. The impartial auditor may ascertain the medical need if local Medicare intermediaries or private guidelines lack clear national standards and frequently random modifications.

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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. million health care providers who are enrolled in the Medicare FFS program. Activities done by MACs.

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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.

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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.

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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

DECEMBER 30, 2024

While its therapeutic benefits are well-recognized, the process of billing for CBT can be complex and often confusing for mental and behavioral health providers. This article serves as a detailed guide for providers, addressing key aspects of CBT billing to ensure compliance, accuracy, and maximize reimbursement.

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Medisys Compliance

DECEMBER 30, 2024

To outsource medical billing services means to delegate billing and coding tasks to third-party companies that specialize in these processes. These companies handle tasks like claim submissions, payment postings, and compliance with healthcare regulations.

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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

JULY 17, 2024

Whether you are an oncologist or an oncology biller, understanding these changes is vital for optimizing your billing practices and ensuring compliance with regulatory standards. Audit and Compliance: Conduct periodic audits to ensure compliance with the new guidelines. Key Changes in Coding Guidelines 1.

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Medisys Compliance

JANUARY 11, 2024

Audits: Increased scrutiny from Medicare and Medicaid for potential coding discrepancies. Documentation Burden Detailed documentation is crucial for supporting claims and ensuring compliance with regulations. Proper medical terminology and abbreviations. Regulatory updates and compliance requirements.

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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

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.

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