Medisys Compliance

NOVEMBER 26, 2024

Skilled Nursing Facility (SNF) billing compliance is a critical aspect of healthcare revenue cycle management, ensuring accurate reimbursement and adherence to Medicare regulations. This article covers the essentials of SNF billing compliance, including processes, guidelines, exclusions, and practical tips for providers.

Compliance 52

Compliance Medical Billing Outsourcing Medicare Medicare 52

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

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

MARCH 14, 2023

Wound care is provided in various healthcare settings like inpatient hospital, outpatient clinics, long-term care facilities, home health settings, hospice and skilled nursing facilities. The MPFS is a payment system that reimburses healthcare providers for services rendered to Medicare patients in an outpatient setting.

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52

Medisys Compliance

MAY 30, 2022

These regulations are the basis for Medicare guidelines. There is no specific Medicare-approved form for PCS. Regardless of the form you choose to use, the information on the form must comply with Medicare guidelines. Note: Medicare requires that services provided/ordered be authenticated by the author. Reference: [link].

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Medicare Medicare 52

Medisys Compliance

JULY 18, 2022

In the Balanced Budget Act of 1997, Congress mandated that payment for the majority of services provided to beneficiaries in a Medicare covered SNF stay be included in a bundled prospective payment made through the Part A Medicare Administrative Contractor (MAC) to the SNF. This practice created several problems. To summarize.

Medical Billing 52

Medical Billing Medicare Medicare Medical Billing Outsourcing 52

Medisys Compliance

AUGUST 8, 2022

In this article, we shared billing guidelines for anesthesia payment at personally performed rate and calculation of anesthesia time units. We referred Medicare billing guidelines from Medicare claims processing manual chapter 12.50 Reference: Medicare Claims Processing Manual Chapter 12.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicare Medicare 52

Medisys Compliance

AUGUST 12, 2022

CMS recently introduced guideline changes to its Medicare reporting rules that impact physician assistant (PA) and nurse practitioner (NP) billing. Let’s understand revised billing guidelines for physician assistant (PA) and nurse practitioner (NP) billing. Revised Billing Guidelines for PA/ NP Billing.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medicare Medicare Nurses 52

Medisys Compliance

FEBRUARY 20, 2022

Note that, incident-to services are only applicable to Medicare. Incident-to services are only applicable for charges billed to a Medicare contractor. You will have to verify with each private insurance carrier on how to bill for services performed by an NPP. Billing Requirements for ‘Incident-to’ Services.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Medicare Medicare 52

Medisys Compliance

APRIL 14, 2022

The Advance Beneficiary Notice of Noncoverage (ABN) i.e., form CMS-R-131, is issued by providers (including independent laboratories, home health agencies, and hospices), physicians, practitioners, and suppliers to Original Medicare (fee for service – FFS) beneficiaries in situations where Medicare payment is expected to be denied.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Medisys Compliance

FEBRUARY 26, 2024

Key Strategies for Success Mastering the bundled payments and episode based billing in cardiology care requires implementing the following strategies: Care Pathway Standardization: Develop standardized care pathways and protocols for common cardiac procedures and conditions to streamline care delivery and optimize resource utilization.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Patient Satisfaction Medicaid 59

Medisys Compliance

MARCH 10, 2022

This information includes details such as disease-specific care plans, adjustments in medication regimens ongoing communication with specialists and more. The biggest reason for recoupment is that diagnoses for which CCM is performed don’t meet billing criteria or Medicare program integrity rules; and it may be true for PCM.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing COVID-19 Medicare 52

Medisys Compliance

AUGUST 20, 2024

Advanced Practice Registered Nurses (APRNs) with a focus on mental health: APRNs, including nurse practitioners and clinical nurse specialists with a psychiatric specialization, can diagnose and treat mental health conditions, often with prescriptive authority.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Licensing Medical Billing Informed Consent 59

Medisys Compliance

FEBRUARY 14, 2022

For providers who primarily provide care for older patients, the process is even more complex due to stringent Medicare regulations and idiosyncrasies specific to each care environment that impact the coding and documentation required for reimbursement. Ambulatory Setting.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicare Medicare 52

Medisys Compliance

FEBRUARY 5, 2024

Unlike traditional physician billing or facility billing, ASC billing involves a blend of both. The facility fee covers the use of the ASC’s resources, including the operating room, equipment, and nursing staff. The Crucial Role of PCPs in ASCs PCPs play a crucial role in the ASC ecosystem.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

MARCH 27, 2023

Defining Provider Credentialing Provider credentialing in healthcare refers to the process of verifying and evaluating the qualifications, credentials, and background of healthcare providers, such as physicians, nurses, and other allied healthcare professionals, before allowing them to provide care to patients.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Malpractice Governance Patient Satisfaction 52

Medisys Compliance

APRIL 11, 2022

Complete documentation will support all procedure codes your billed and will provide complete picture for payers. In this article, we shared list of required documents for ambulatory surgery centers who are beneficiaries of Medicare. Pre-operative medical record documentation. Nurses’ notes. Informed consent.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Informed Consent Nurses 52

Medisys Compliance

MARCH 10, 2024

To learn more about our wound care billing services, contact us at 888-720-8884 / info@medisysdata.com References: National Association for Home Care & Hospice (NAHC) Official Website Wound Ostomy and Continence Nurses Society (WOCN) Official Website The post Navigating the Complexities of Wound Care Billing in 2024 appeared first on Leading Medical (..)

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing COVID-19 Nurses 59

Medisys Compliance

MARCH 31, 2023

License or certification: You may need to provide proof that you are licensed or certified to practice in your field, such as a copy of your nursing license or medical degree. We can assist you in getting enrolled for Medicare, Medicaid and all major commercial insurance companies in your area.

Medicaid 52

Medicaid Medicaid Licensing Medical Billing Outsourcing 52

Medisys Compliance

MARCH 8, 2023

Compliance: Wound care providers must comply with a range of regulations, including Medicare and Medicaid guidelines, HIPAA privacy rules, and local and state regulations. Auditors should ensure that billing practices are in compliance with these rules and regulations.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Compliance Medicare 52

Medisys Compliance

JULY 25, 2023

Minor visits, such as blood pressure checks or weight checks, can be conducted by a nurse or medical assistant without the patient seeing the physician. In such cases, the established office visit code 99211 may be billed as long as there is an element of evaluation and management, such as counseling or discussion of medication.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Nurses Compliance 52

Medisys Compliance

MAY 9, 2022

These modifiers are required to be used for therapy services furnished by providers that submit institutional claims, including the provider types: outpatient hospitals, rehabilitation agencies, skilled nursing facilities, home health agencies and comprehensive outpatient rehabilitation facilities (CORFs).

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Medicare Medicare 52

Medisys Compliance

MARCH 16, 2022

The quickest way to boost cash flow is to cut costs, but for medical practices, most costs are usually salaries. Practices need to understand the costs of physicians, nurses, and office staff and be willing to make adjustments based on forecasts. Manage Cost. In the down months, hours should be reduced.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medical Billing Services Nurses 52

Medisys Compliance

DECEMBER 16, 2024

Skilled Nursing Facility (SNF) Medicare Part B billing is a specialized area of medical billing that requires detailed knowledge of Medicare guidelines, consolidated billing rules, and exclusions. These include physician visits, certain therapies, diagnostic tests, and durable medical equipment (DME).

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

Medisys Compliance

NOVEMBER 27, 2024

Medicare covers certain podiatry services, but billing for them requires strict adherence to guidelines to ensure compliance and maximize reimbursement. What Does Medicare Cover for Podiatry Services? Routine Foot Care Exceptions: Medicare covers routine foot care (e.g., nontraumatic amputation of a foot).

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Medicare Medicare Medical Billing Outsourcing Medical Billing 59