Medisys Compliance

MAY 19, 2022

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. 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.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 52

Medisys Compliance

MARCH 31, 2023

Ohio Medicaid is a government-sponsored healthcare program that provides medical benefits to eligible individuals in Ohio. To become a provider for Ohio Medicaid, you must first enroll in the Ohio Medicaid program. Here are the steps of provider enrollment for Ohio Medicaid: Provider Enrollment for Ohio Medicaid 1.

Medicaid 52

Medicaid Medicaid Licensing Medical Billing Outsourcing 52

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

DECEMBER 19, 2024

Podiatrists provide essential care for foot and ankle conditions, but the complexities of podiatry billing often create administrative burdens. From managing CPT codes for procedures like nail debridement and wound care to ensuring compliance with Medicares podiatry-specific guidelines, the billing process can be confusing.

Medical Billing Outsourcing 66

Medical Billing Outsourcing Medicare Medicare Compliance 66

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

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

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

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.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 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. 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.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

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

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. Trust Medisys for comprehensive radiology billing services tailored to your needs.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

APRIL 11, 2024

Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) can now directly bill Medicare for services they furnish and diagnose. Eligibility and Covered Services To directly bill Medicare, you must meet specific eligibility criteria. The next step involves enrolling as a Medicare provider.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

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.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 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. Medicare Coverage. Only a qualified home infusion therapy supplier can bill for services under the new home infusion therapy services benefit.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Medisys Compliance

FEBRUARY 19, 2024

Additional Considerations In-network vs. out-of-network billing: Understand the differences in reimbursement rates, patient responsibility, and billing procedures for in-network and out-of-network claims. Medicare and Medicaid billing: These programs have specific regulations and coding requirements for group therapy billing.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medical Billing Medicaid 59

Medisys Compliance

JANUARY 11, 2024

Audits: Increased scrutiny from Medicare and Medicaid for potential coding discrepancies. Proper medical terminology and abbreviations. Regulatory Landscape Medicare and Medicaid regulations change frequently, demanding constant adaptation. Delays: Reimbursement postponed while errors are corrected.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medical Billing Medicaid 59

Medisys Compliance

MAY 20, 2024

Payer type: Private insurance companies, Medicare, and Medicaid have their own reimbursement structures. Payer Websites: Insurance companies and government agencies (Medicare, Medicaid) often publish reimbursement rates on their websites.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

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?

Medicare 52

Medicare Medicare Medical Billing Outsourcing Health Outcomes 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

APRIL 23, 2024

Stay Current on Regulations and Coding Updates Monitor Regulatory Changes: Stay informed about updates to regulations like MACRA (Medicare Access and CHIP Reauthorization Act) that may impact your billing practices. Utilize resources from the Centers for Medicare & Medicaid Services (CMS) and your local healthcare associations.

Medical Billing 59

Medical Billing Medical Billing Outsourcing 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

JULY 17, 2024

Reference Links American Society of Clinical Oncology (ASCO) – Coding and Reimbursement Centers for Medicare & Medicaid Services (CMS) – Medicare Claims Processing Manual CPT® Copyright 2024 American Medical Association. All rights reserved.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicare 59

Medisys Compliance

APRIL 1, 2024

Patient Consent: Ensure patients have consented to receiving telehealth services and understand potential billing implications. Maximizing Reimbursement for Telehealth Services Stay Informed: Keep yourself updated on the latest telehealth billing regulations from Medicare, Medicaid, and private insurers.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing COVID-19 Medicaid 59

Medisys Compliance

APRIL 18, 2022

In October 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced a goal of having every Medicare beneficiary and the majority of Medicaid beneficiaries covered by some type of alternative payment model (APM) by 2030. In order to do so, a clinician must be in a Medicare Advanced APM.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicaid Medicaid 52

Medisys Compliance

APRIL 10, 2024

But navigating the complexities of HBOT billing can be daunting. Understanding Coverage and Coding Medicare reimbursement for HBOT hinges on the diagnosis. You’ll need to establish medical necessity by linking the therapy to the specific diagnosis and demonstrating that conventional therapies have failed.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59

Medisys Compliance

APRIL 22, 2022

In the Medicare Physician Fee Schedule final rule issued in November 2021, the Centers for Medicare and Medicaid Services (CMS) added four new CPT codes (99424, 99425, 99426, and 99427) in the category of Principal Care Management (PCM) to replace the two previous PCM codes (HCPCS codes G2064 and G2065).

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Medicare Medicare 52

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

MARCH 15, 2024

References: American Medical Association: “Current Procedural Terminology (CPT®) Codes Centers for Medicare & Medicaid Services (CMS): Medicare Modifiers The post RIAS Coding for Urology: Optimizing Reimbursement appeared first on Leading Medical Billing Outsourcing Services Company in the USA.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

AUGUST 4, 2022

The Centers for Medicare & Medicaid Services (CMS) on June 21, 2022, issued a proposed rule that proposes to update payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2023.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

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

JUNE 28, 2022

Medicare Coverage for Continuous Glucose Monitors (CGMs). On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule in the Federal Register that addressed the classification and payment of continuous glucose monitors (CGMs) under the Medicare Part B benefit for durable medical equipment (DME).

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Medicare Medicare 52

Medisys Compliance

FEBRUARY 26, 2024

References: Centers for Medicare & Medicaid Services (CMS) – Bundled Payments for Care Improvement (BPCI) Initiative Episode-Based Cost Measure Development for the Quality Payment Program The post Mastering Bundled Payments and Episode Based Billing in Cardiology Care appeared first on Leading Medical Billing Outsourcing Services Company (..)

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Patient Satisfaction Medicaid 59

Medisys Compliance

APRIL 20, 2022

We shared billing update for free COVID-19 tests and second free booster dose in detail in this article. Medicare to Cover Over-the-Counter COVID-19 Tests. People with Medicare can get up to eight tests per calendar month from participating pharmacies and health care providers for the duration of the COVID-19 public health emergency.

COVID-19 52

COVID-19 COVID-19 Vaccine Medical Billing Medicare 52

Medisys Compliance

FEBRUARY 9, 2024

Hospital Outpatient Prospective Payment System (OPPS) Updates OPPS is a payment system used by Medicare to reimburse hospitals for outpatient services, including some wound care procedures. The Centers for Medicare & Medicaid Services (CMS) issues annual updates to the OPPS payment rates and co-payment amounts.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

Medisys Compliance

JULY 31, 2024

Key considerations include: Medicare: Medicare has established specific coverage criteria for various immunotherapies. Medicaid: Coverage and reimbursement policies differ by state. Avoiding Common Billing Errors Preventing billing errors is critical to ensuring timely and accurate reimbursement.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59

Medisys Compliance

MARCH 14, 2023

DRGs are a payment classification system used by Medicare and other insurance providers to categorize patients into groups based on their diagnosis, severity of illness, and the resources required for their care. Hospitals are paid a fixed amount for each DRG, regardless of the actual cost of the care provided.

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52