Medisys Compliance

MARCH 5, 2024

Payer Audits and Reimbursement Challenges in Cardiology Billing Common Challenges in Cardiology Billing Coding Complexity: Cardiology procedures often involve multiple components and intricacies that require accurate coding to reflect the level of service provided.

Medical Billing Outsourcing 105

Medical Billing Outsourcing Medical Billing Compliance Governance 105

Medisys Compliance

FEBRUARY 19, 2024

Diagnosis Drives Reimbursement: Accurately document diagnoses using ICD-10 codes that align with the group’s focus and individual client needs. Ensure diagnoses support the medical necessity of group therapy for each participant. If you treat Medicare or Medicaid patients, ensure you have the necessary knowledge and resources.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

JULY 31, 2024

Documentation Requirements Detailed documentation is crucial for supporting the medical necessity of immunotherapy. Comprehensive documentation ensures transparency and supports claims during audits. Some payers may require prior authorization, while others have specific documentation requirements.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59

Medisys Compliance

AUGUST 11, 2024

Understanding Mental Health Billing Mental health billing involves the submission and management of claims to insurance companies for services provided by mental health professionals, including psychologists, psychiatrists, counselors, and social workers. Key Components of Mental Health Billing 1. All rights reserved.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Services Medical Billing Regulatory Compliance 52

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

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

APRIL 25, 2024

MIPS focuses on four key performance categories: Quality: This measures the quality of care you provide to your patients based on specific metrics established by the Centers for Medicare & Medicaid Services (CMS). Reporting accurate data for cardiology-specific quality measures is crucial.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

Medisys Compliance

AUGUST 20, 2024

Common codes include: 90832: Psychotherapy, 30 minutes 90834: Psychotherapy, 45 minutes 90837: Psychotherapy, 60 minutes 90791: Psychiatric diagnostic evaluation 90792: Psychiatric diagnostic evaluation with medical services These codes must be selected based on the time spent and the complexity of the service provided.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Licensing Medical Billing Informed Consent 59

Medisys Compliance

FEBRUARY 21, 2024

Billing Components of CPT Code 59400 Antepartum Care: Antepartum care includes all prenatal visits and services provided to the pregnant patient before delivery. Each antepartum visit should be documented thoroughly, including the history, physical examination, medical decision-making, and any procedures or interventions performed.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicaid 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 guidelines cover various aspects of billing, including CPT codes, HCPCS codes, ICD-10 codes, and documentation requirements.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medicaid Medicaid 59

Medisys Compliance

APRIL 1, 2024

Documentation Requirements: Maintain thorough documentation of the telehealth encounter, including the communication method (video, audio-only, etc.), Patient Consent: Ensure patients have consented to receiving telehealth services and understand potential billing implications. Stay updated on your state’s regulations.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing COVID-19 Medicaid 59

Medisys Compliance

APRIL 23, 2024

Implement Regular Audits: Regularly audit your billing processes to identify and address any coding inconsistencies or documentation gaps. missing information, coding errors) and have a clear process for appealing denials with proper documentation. This fosters trust and reduces billing surprises.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

AUGUST 30, 2024

Key CPT and ICD-10 Codes for Pain Management Accurate coding is the foundation of successful anesthesiology billing for pain management. It ensures that services are correctly documented, billed, and reimbursed. Medical Necessity: Establishing medical necessity is critical for securing reimbursement.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicaid 59

Medisys Compliance

JUNE 26, 2024

Introduction In mental health care, accurate documentation and coding are pivotal for effective treatment planning, patient care, and reimbursement. Detailed Documentation Thorough documentation of the patient’s symptoms, history, and diagnosis is crucial. Bipolar Disorder: F31.0 – F31.9; Schizophrenia: F20.0 – F20.9

Medical Billing 45

Medical Billing Medical Billing Outsourcing Medicaid Medicaid 45

Medisys Compliance

APRIL 10, 2024

Covered conditions include diabetic foot ulcers with specific criteria (documentation of non-healing for at least 30 days with standard therapy is crucial) as well as gangrene, decompression sickness, gas embolism, carbon monoxide poisoning, and compromised flaps in crush injuries. diabetic foot ulcer – E11.47).

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59

Medisys Compliance

JULY 9, 2024

Angina pectoris with documented spasm I21.01: ST elevation (STEMI) myocardial infarction involving the left main coronary artery I21.4: Angina pectoris with documented spasm I21.01: ST elevation (STEMI) myocardial infarction involving the left main coronary artery I21.4: Use detailed clinical documentation and coding resources.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicaid 59

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. Session Structure: The duration, frequency, and content of group sessions impact billing and documentation requirements.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medical Billing Regulatory Compliance 59

Medisys Compliance

MAY 17, 2024

Medical Necessity: Payers may deny claims if they deem the service not medically necessary. This often involves providing clear documentation justifying the treatment plan. Missing or Incomplete Information: Claims with missing documentation or unclear notes may be denied for further review.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 59

Medisys Compliance

JULY 23, 2024

CPT Code 77427: This code for radiation treatment management has been revised to better delineate between simple and complex treatment plans, ensuring appropriate billing for the level of service provided. Compliance and Documentation Tips Accurate documentation is crucial for compliance and reimbursement in radiation oncology billing.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Informed Consent Medical Billing 59

Medisys Compliance

JULY 15, 2024

Revised Evaluation and Management (E/M) Codes E/M codes have undergone significant revisions to simplify the documentation process and better reflect the work involved in patient care. Invest in Training: Ensure that your billing and coding staff are well-trained on the new codes and billing requirements.

Medicare 59

Medicare Medicare Medical Billing Outsourcing COVID-19 59

Medisys Compliance

MARCH 15, 2024

For proper reimbursement, ensure your medical records clearly document the specific hormone or substance measured in the RIA test. Also document the medical reason for ordering the RIA test, linking it to the patient’s diagnosis and treatment plan. Stay updated on coding changes: CPT codes are periodically revised.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

AUGUST 29, 2024

Ensure that the documentation accurately reflects the nature of the service provided and the time involved. Accurate documentation is crucial for justifying the medical necessity of the service and ensuring compliance with payer requirements. These codes vary based on the time spent on the visit and the level of care provided.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medical Billing Services 59

Medisys Compliance

DECEMBER 29, 2023

Introduction The realm of cardiology encompasses a vast array of specialized services and procedures, demanding precise documentation and accurate coding for proper reimbursement. This article serves as a detailed guide, unpacking the details of this CPT code range 92920-93793 and its applications within cardiology billing.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

MARCH 7, 2024

Consequently, staying informed about these updates is imperative for healthcare professionals to accurately document and bill for services rendered. Similarly, revisions to existing codes may reflect updates in procedural techniques or changes in documentation requirements.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Regulatory Compliance COVID-19 59

Medisys Compliance

MAY 22, 2024

Optimizing Your Workflow for Accurate Billing Verify Patient Insurance and Benefits: Before each session, confirm the patient’s insurance is active and understand their mental health coverage details (deductibles, copays, covered services). Detailed Documentation: Maintain thorough notes for each session.

Compliance 59

Compliance Medical Billing Services Medical Billing Medical Billing Outsourcing 59

Medisys Compliance

FEBRUARY 13, 2024

In progress notes, document session duration, interventions, and treatment plan goals. When family members are involved, utilize specific code modifiers (-96, -97) and submit detailed clinical documentation demonstrating medical necessity. Ensure informed consent is obtained for treatment and billing practices.

Medical Billing Outsourcing 69

Medical Billing Outsourcing Informed Consent Medical Billing Compliance 69

Medisys Compliance

NOVEMBER 30, 2023

Defining Urology Denials Urology denials management refers to the rejection of claims for urological services due to various reasons, including coding errors, documentation deficiencies, eligibility issues, lack of prior authorizations, and disputes over medical necessity.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 59

Medisys Compliance

AUGUST 14, 2024

Authorization: Obtaining prior authorization for treatments and medications is a time-consuming but essential step to prevent claim denials. Treatment and Documentation: Detailed and accurate documentation of patient care, including diagnoses, procedures, and medications, is critical for proper coding and billing.

Patient Satisfaction 52

Patient Satisfaction Medical Billing Outsourcing Medical Billing Medicaid 52

Medisys Compliance

JANUARY 4, 2024

Code selection hinges on the time spent, complexity of medical decision-making, and four key elements: history, examination, medical decision-making, and counseling/coordination of care. Required Documentation Solid medical documentation is your armor against denials and audits.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medical Billing Services 59

Medisys Compliance

AUGUST 23, 2024

Involving clinical staff in these audits can also provide insights into the accuracy of clinical documentation, which directly impacts coding precision. Upon audit, it was found that the codes used did not align with the documented treatment protocols. Practical Tip: Regularly review denied claims to identify patterns in coding errors.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

MAY 3, 2024

This guide will equip you with the knowledge to decipher these often-confusing documents. An EOB is a document sent by an insurance company to a patient after a healthcare service is rendered. Gather Supporting Documentation: If necessary, gather documentation to justify the service, such as treatment notes or progress reports.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

MAY 27, 2024

Streamlining Your GI Billing Process Patient Insurance Verification: Before each encounter, confirm the patient’s insurance is active and understand their GI coverage details (deductibles, co-pays, covered services). Accurate Documentation: Maintain thorough medical records for each patient.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Hospitals 59

Medisys Compliance

OCTOBER 18, 2023

Document the interpretation: The EKG interpretation should be documented by a qualified healthcare professional, such as a cardiologist, who has the necessary expertise to analyze the results accurately. Ensure accurate documentation: Accurate documentation is crucial for proper coding and billing.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicaid Medicaid 59

Medisys Compliance

JANUARY 21, 2024

Documentation Requirements: Documentation demands could increase to justify new services and comply with parity mandates. Maintain meticulous documentation and stay updated on evolving billing guidelines to reduce audit risks. We can: Stay updated on billing regulations and codes related to the omnibus bill.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59

Medisys Compliance

NOVEMBER 8, 2023

Mental health providers should be aware of the rules and regulations set forth by the Centers for Medicare and Medicaid Services (CMS) and other federal agencies. Payer Policies: Private insurance companies, Medicaid, and Medicare have varying policies regarding telehealth reimbursement.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medicaid Medical Billing 59

Medisys Compliance

MARCH 10, 2024

However, billing for telehealth services involves navigating complex regulations and payer policies. Understanding the requirements for telehealth reimbursement and documenting services appropriately are crucial aspects of successful billing in this evolving landscape.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing COVID-19 Nurses 59

Medisys Compliance

FEBRUARY 29, 2024

Ensuring Documentation Accuracy Proper documentation remains the cornerstone for successful reimbursement in virtual care: Detail the Virtual Encounter: Document the nature of the virtual visit, including the specific technology used, the duration of the interaction, and any pertinent clinical findings.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Informed Consent Medical Billing Medicare 59