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CMS Update: Telehealth Restrictions Lifted (03-17-20)

In response to the coronavirus public health emergency, CMS has broadened access to Medicare telehealth services.

Click here for the Medicare Telemedicine Health Care Provider Fact Sheet

Click here for the Medicare Telehealth Frequently Asked Questions (FAQs)

Points to Note:

  1. Practices may now render full E&M services to patients in areas where there is no shortage of providers (99211-215 with appropriate modifiers appended).

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COVID-19 Billing: Telehealth and Other Communication-Based Technology Services

With the overload of information coming in regarding coronavirus, it can become difficult to keep abreast of the changes being made.

Here are some excerpts from the Medicare Fact Sheet on CMS coverage guidelines for telehealth services dated 03/05/2020:

Telehealth and Other Communication-Based Technology Services

Beneficiaries can communicate with their doctors or certain other practitioners without necessarily going to the doctor’s office in person for a full visit.

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Difference between EHR and Practice Management Software

Digital record keeping is here to stay – and is evolving in leaps and bounds. The vast array of hardware and software available can be confusing to even those well versed with the current digital technology. In order to differentiate between the vast arrays of available technology, industries tend to create their own vernacular for them.

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Importance of Clinical Documentation Improvement

In the current healthcare scenario, every patient encounter requires to be documented – both for future reference as well as for the facility to be reimbursed for the services performed. With the increase in healthcare services, the quantum of data has also increased manifold times. Along with increasing in sheer quantity, clinical data is also becoming increasingly complex.

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Effective Claim Denial Management Strategies

According to the AMA’s health insurer report card, denial rates of claims for major private payers ranged between 0.54% and 2.64%. At the same time, denial rates for Medicare stood at close to 5%. Although the percentage does not sound like too much, given the fact that billions of dollars are claimed each year, the figures for denied claims suddenly assumes gigantic proportions.

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12 Tips on Reducing Patient Wait Times in the Clinic

The few picture frames on the wall showcase degrees and awards that have been bestowed a long time back. The magazines on the table are mostly journals – and old ones at that. Other than the soft humming of the air conditioner and the ticking of the seconds hand on the wall clock, the room is silent.

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CPT Coding for Dermatology

Dermatology Coding Challenges

According to ‘Coding 2017 and beyond’, an article published in the Dermatology Times, dermatologists should be prepared for increased audits by Medicare’s CERT (Comprehensive Error Rate Testing) program, OIG, ZPIC and the RAC of their dermatology billing. In order to avoid these increased audits, dermatologists will need to submit detailed documentation which has to include histopathology with Mohs operative notes.

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Managing Revenue Cycle Management Metrics

Your medical practice has never had it so good. The number of patients is increasing and you have enough left over after paying all your overhead expenses and bills. You even have enough left over to take that European holiday after paying off your mortgage and the household bills. Wow! You are doing well and your practice is earning money….or is it?

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Improve Denial Management

Globally, medical practices are facing tough financial times. The growing population coupled with the rise in new diseases is taking its toll on the healthcare system. Healthcare claims are coming under intense scrutiny, and the ever-increasing paperwork and frequently changing laws ensure compliance issues being faced by a medical practice. One of the critical challenges facing medical practices is claims denial.

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Why Should You Outsource Your Medical Billing

Why outsource RCM

A highly challenging and demanding task, medical billing is one of the pillars on which your organization stands. Mistakes made in your medical billing can sink your practice faster than the Titanic. While there are definite advantages to having your own medical billing staff, the advantages of outsourcing your medical billing far outweigh them.

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