Medisys Compliance

APRIL 11, 2022

Billing for Ambulatory Surgery Centers (ASCs) is tightly regulated by numerous federal as well as state-level regulatory authorities. Complete documentation will support all procedure codes your billed and will provide complete picture for payers. Pre-operative medical record documentation. Discharge documentation.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Informed Consent Nurses 52

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

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

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

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

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. Coding Guidelines. All Rights Reserved.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 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

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

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

AUGUST 23, 2024

The compliance process involves understanding and following payer-specific guidelines, particularly those set by Medicare. Example: Medicare’s guidelines for oncology coding are detailed and specific. Example: Medicare guidelines often change, particularly regarding how certain treatments like radiation therapy should be coded.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 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. 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

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. Only complete or sufficient documentation can result in claim denials or downcoding.

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

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 10, 2024

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. Medically Unlikely Edits (MUEs): Medicare has MUEs in place for HBOT, limiting daily billing to five 30-minute units.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 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

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. Key considerations include: Medicare: Medicare has established specific coverage criteria for various immunotherapies.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing 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

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 21, 2024

Understanding the Bill and its Implications The mental health omnibus bill encompasses a multitude of provisions aimed at bolstering mental health resources and services. Mental Health Billing and the Mental Health Omnibus Bill These changes will undoubtedly affect billing practices.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59

Medisys Compliance

JULY 16, 2024

Common CPT codes for mental health services include: 90791: Psychiatric diagnostic evaluation 90834: Psychotherapy, 45 minutes with patient 90837: Psychotherapy, 60 minutes with patient 2. Documentation Requirements Proper documentation is essential for justifying the services provided. Recent changes include: 1.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 59

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 Medical Billing Medicaid Medicaid 59

Healthcare IT Today

JUNE 29, 2023

ASCs must stay current on healthcare regulations that affect billing. To avoid penalties, maximize revenue, and accurately document claims, ASCs must understand these changes. Understanding ASCs Regulatory Changes and Their Billing Practices Outpatient surgery centers (ASCs) perform many surgical procedures outside of hospitals.

Compliance 52

Compliance Medicare Medicare Medical Billing 52

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

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

APRIL 5, 2024

Some common modifiers used in MPI billing include: 59 (Distinct procedural service): Used if a separate and medically necessary service is performed on the same day as the MPI (e.g., Medicare Coverage and Reimbursement MPI is covered by Medicare under specific conditions.

Medical Billing 64

Medical Billing Medical Billing Outsourcing Medicare Medicare 64

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

AUGUST 29, 2024

E-visit Codes: Typically, there are specific codes designated for e-visits that cover remote evaluations and management services. Ensure that the documentation accurately reflects the nature of the service provided and the time involved. 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

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

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

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

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

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

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 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

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

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