Medisys Compliance

JANUARY 16, 2025

Behavioral health providers play a critical role in addressing mental health challenges, but navigating the complexities of billing can be daunting. The Centers for Medicare & Medicaid Services (CMS) provides comprehensive behavioral health billing guidelines, which can be overwhelming due to their technical nature and breadth.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Fraud 59

Medisys Compliance

MARCH 12, 2025

Cardiology practices frequently interact with a diverse landscape of payers – from Medicare and Medicaid to a multitude of commercial insurance companies. Incomplete Documentation The pressure of patient care often overshadows the equally important task of detailed and precise documentation by physicians.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 59

Medisys Compliance

MARCH 24, 2025

Unlike traditional primary care, urgent care centers handle a mix of walk-in patients with varying levels of acuity, which creates a complex billing environment. Efficient billing ensures your urgent care facility gets reimbursed accurately and promptly. This is typically applicable to Evaluation and Management (E/M) services.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicaid 59

Medisys Compliance

MARCH 18, 2025

Behavioral and mental health practices face unique billing challenges that are very different from other medical specialties. Complex documentation requirements, evolving payer guidelines, and the nuances of time-based coding can make managing the revenue cycle a daunting task for outpatient mental health providers.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medical Billing HIPAA 59

Medisys Compliance

JULY 19, 2024

Introduction The landscape of Medicare and Medicaid billing for behavioral health services has undergone significant changes recently. This article discusses the latest changes, providing a comprehensive guide to navigating the evolving billing landscape.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Medisys Compliance

APRIL 19, 2023

The Medicaid program in Florida provides medical services and assistance to low-income individuals and families. To participate in the Medicaid program, healthcare providers must meet several general requirements set forth by the Agency for Health Care Administration (AHCA).

Medicaid 52

Medicaid Medicaid Medical Billing Outsourcing Licensing 52

Medisys Compliance

JANUARY 23, 2025

Providers must remain vigilant about evolving policies, especially concerning geographic and site-of-service requirements that may change post-March 2025. Mental health providers should monitor updates from the Centers for Medicare & Medicaid Services (CMS) to ensure uninterrupted reimbursement. Service delivery mode (e.g.,

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Medical Billing 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

DECEMBER 18, 2024

Compliance and Regulatory Expertise Primary care billing must comply with evolving regulations such as Medicare billing updates, preventive care mandates, and documentation requirements. Outsourced billing partners ensure adherence to these regulations, minimizing compliance risks.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 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

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

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

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. Eligibility Issues: Patient insurance coverage may be inactive, lack specific benefits, or require prior authorization for certain services.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 59

Medisys Compliance

AUGUST 27, 2024

This guide provides a detailed, technical overview of the key aspects involved in CPT coding for PT, helping you optimize your practice’s billing processes. Overview of CPT Codes in Physical Therapy CPT codes are used to describe medical, surgical, and diagnostic services.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Compliance 59

Medisys Compliance

AUGUST 11, 2024

As a leading provider of medical billing services, we understand the difficulties and challenges faced by therapists in managing their billing processes. Accurate and efficient billing is crucial for maintaining a stable cash flow and ensuring that therapists are reimbursed for their services.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Services Medical Billing Regulatory Compliance 52

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. Radiology practices must stay updated on these regulations to ensure compliance.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

APRIL 26, 2024

Essential Considerations for Accurate Outpatient Billing Accurate Documentation: Detailed and clear physician documentation is vital for accurate coding. Documentation should reflect the history of present illness, review of systems, medical decision-making, physical examination findings, and assessment/plan.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Patient Satisfaction 59

Medisys Compliance

JUNE 14, 2023

Implementing advanced billing software that incorporates compliance checks and built-in coding assistance can help reduce coding errors and mitigate compliance risks. Documentation and Coding Accuracy Accurate documentation and coding play a vital role in medical billing.

Medical Billing 52

Medical Billing Medical Billing Services Medical Billing Outsourcing Regulatory Compliance 52

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. Efficient documentation practices and record-keeping systems.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medicaid Medical Billing 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. Thorough Documentation: Comprehensive and accurate documentation is the cornerstone of proper coding and billing.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Telemedicine 59

Medisys Compliance

FEBRUARY 13, 2025

Importance of Code Specificity: Always select the most specific CPT code that accurately reflects the service provided, based on thorough documentation. It is crucial to ensure a clear and documented link between the ICD-10 diagnosis code and the CPT procedure code billed. are performed.

Medical Billing 59

Medical Billing Medical Billing Services Medical Billing Outsourcing Medicaid 59

Medisys Compliance

JULY 27, 2023

How do I ensure compliance with Kentucky Medicaid and Medicare billing guidelines? Training and education: Ensure that the billing and coding staff receive appropriate training on Kentucky Medicaid and Medicare guidelines. Documentation accuracy: Accurate and complete documentation is vital for billing compliance.

Medical Billing 52

Medical Billing Telemedicine Medicaid Medicaid 52

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 Medicaid Medicaid Medical Billing 59

Medisys Compliance

JULY 17, 2024

The revised codes now emphasize the duration and specificity of the infusion, requiring detailed documentation of the time and type of drugs administered. This change aims to simplify billing and reduce the chances of claim denials. Documentation Requirements Detailed documentation is now more critical than ever.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicare 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. Contact us today for a free consultation.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medicaid Medicaid 59

Medisys Compliance

OCTOBER 18, 2023

Following are some guidelines to follow when using this procedure code: Correctly identify the service: Ensure that the service being coded is the interpretation and report of an EKG, not the performance of the EKG test itself. 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

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

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

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

MAY 4, 2023

Some of the common challenges include: Complex coding: Oncology medical billing requires accurate and detailed coding of diagnoses, procedures, and medications. This can be challenging due to the complex nature of cancer treatment and the need for precise documentation.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medical Billing Services Compliance 52

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

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

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

APRIL 8, 2024

Precise Coding: Utilize the latest versions of ICD-10 (diagnosis codes) and CPT (procedure codes) to ensure accurate representation of services rendered. Detailed Documentation: Maintain clear and concise medical records that document the patient’s condition, treatment plan, and medical necessity for services.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Patient Satisfaction 59

Medisys Compliance

DECEMBER 10, 2024

Understanding Spine Surgery Billing Spine surgery billing involves multiple layers of documentation and coding to account for various procedures, instrumentation, and levels of the spine addressed. The accuracy of this billing process directly impacts reimbursement rates and the financial health of a practice.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Compliance Medicaid 59

Medisys Compliance

JULY 26, 2022

The Centers for Medicare and Medicaid Services (CMS) is responsible for devising the audit strategy and enforcing it on a year-to-year basis. CMS also provides documents online to help you further understand the process in more detail. CMS also provides documents online to help you further understand the process in more detail.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 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