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.

HIPAA 59

HIPAA Compliance Medical Billing Outsourcing Medical Billing 59

Medisys Compliance

DECEMBER 23, 2022

The internet is ringing with the news of the CMS Updates Final rule for the 2023 Medicare Physician Fee Schedule. The finalized 2023 Medicare Physician Fee Schedule was announced by the Centers for Medicare & Medicaid Services (CMS) on November 1 2022. Medicare reimbursement for telehealth services.

Medicare 98

Medicare Medicare Medical Billing Medical Billing Outsourcing 98

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.

Compliance 59

Compliance Medical Billing Outsourcing Medical Billing ACA 59

Healthcare IT Today

JUNE 29, 2023

The following is a guest article by Isaac Smith, Billing, Coding, and Reimbursement Specialist at Medcare MSO ASCs are types of medical facilities that are subject to stringent regulations. However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance.

Compliance 52

Compliance Medicare Medicare Medical Billing 52

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

OCTOBER 1, 2022

Navigating through the complex medicare guidelines can be a complex and overwhelming task, however, here is the good news, the entire process is merely about using the right CPT codes. However, one needs to be careful while billing as Medicare follows strict rules and regulations for time increments.

Medicare 98

Medicare Medicare Medical Billing Outsourcing Medical Billing 98

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

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. If you need any assistance in billing for Medicare, contact us at info@medisysdata.com/ 302-261-9187.

Medicare 97

Medicare Medicare Medical Billing Medical Billing Outsourcing 97

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.

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

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 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

MAY 23, 2024

Introduction The Centers for Medicare & Medicaid Services (CMS) establish specific billing guidelines for behavioral health services provided to Medicare beneficiaries. Providers must understand these guidelines to ensure accurate claims submission, maximize reimbursement, and maintain compliance.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 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

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

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. MAOs also denied payments to providers for some services that met both Medicare coverage rules and MAO billing rules.

Medicare 52

Medicare Medicare US Department of Health and Human Services 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

APRIL 8, 2022

CMS has updated the Telehealth Services List to show minor changes due to various activities, such as the CY 2022 MPFS Final Rule and legislative changes from the Consolidated Appropriations Act of 2021. In this article, we briefly discussed these Medicare telehealth billing guidelines. Temporarily Added Telehealth Services.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 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. Cost-sharing.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 52

Medisys Compliance

AUGUST 27, 2024

Overview of CPT Codes in Physical Therapy CPT codes are used to describe medical, surgical, and diagnostic services. In physical therapy, these codes are essential for documenting the type and extent of services provided. Accurate coding ensures compliance and proper reimbursement.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Compliance 59

Medisys Compliance

AUGUST 23, 2024

Whether you’re dealing with compliance, avoiding common errors, or coding for specialized treatments like chemotherapy and radiation, this guide will help you navigate the complexities of oncology coding rules and guidelines. Example: Medicare’s guidelines for oncology coding are detailed and specific.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

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 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

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

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

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

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. It may also help prevent duplicative practitioner billing.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 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

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.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicare 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. Detailed medical records provide the necessary support for justifying the level of care and ensuring appropriate reimbursement.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Telemedicine 59

Medisys Compliance

AUGUST 21, 2024

In 2024, the Centers for Medicare & Medicaid Services (CMS) introduced several crucial updates to radiation oncology billing guidelines. These changes affect coding, reimbursement, and compliance requirements, making it essential for providers to stay informed to maximize reimbursement and avoid penalties.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medicaid Medicaid 59

Medisys Compliance

JULY 16, 2024

Understanding Mental Health Billing Mental health billing differs from general medical billing in several key ways. The unique nature of mental health services requires specialized billing practices to ensure compliance and maximize reimbursements. Key components include: 1. Recent changes include: 1.

Medical Billing 59

Medical Billing 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

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. Missing out on reimbursement for newly covered services.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

MARCH 13, 2024

Modifier 76 indicates that the same procedure was repeated by the same provider, allowing for accurate billing and reimbursement. This includes maintaining detailed documentation, staying updated on coding changes, and seeking guidance when uncertain about proper billing procedures.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Services Medical Billing Compliance 59

Medisys Compliance

JULY 27, 2023

Medisys Data Solutions (MDS) understand the challenges that healthcare professionals face when it comes to medical billing and coding in Kentucky. The complex landscape of billing regulations, ever-evolving guidelines, and the need for compliance can be overwhelming. This helps maintain compliance and reduce errors.

Medical Billing 52

Medical Billing Telemedicine Medicaid Medicaid 52