Efficient dermatology billing is vital to a practice’s financial health, yet it’s often complicated by payer rule changes, denied claims, and time-consuming prior authorizations. Without the right systems and support, even minor missteps can lead to lost revenue and delayed payments. In this article, we explore the top dermatology billing challenges and the solutions practices […]
Should You Outsource Dermatology Billing? Pros and Cons
Dermatology billing is complex, time-consuming, and increasingly difficult to manage in-house. As billing requirements become more specialized, many practices are weighing whether to outsource to a dermatology billing company. This article explores the pros and cons of each approach to help providers make a more informed decision that supports both short- and long-term success. * […]
Why Specialized Dermatology Billing Services Lead to Better Reimbursements
Accurate billing is essential to the financial health of dermatology practices, but general billing services often fall short. This article explores how specialized dermatology billing support leads to fewer denials, faster reimbursement, and stronger revenue performance by addressing the unique coding and compliance challenges of the specialty. * * * In dermatology, accurate and efficient […]
10 Best Practices to Ensure Successful Credentialing
Whether you operate an in-house credentialing program or outsource your credentialing, there are many best practices to follow to ensure your program delivers timely credentialing and re-credentialing results that do not keep your physicians from providing care. Here are 10 helpful tips to help ensure your physicians are successfully credentialed and re-credentialed, and provide the […]
10 Tips for Complying With Laboratory Services Documentation Requirements
The Centers for Medicare & Medicaid Services (CMS) reported that the majority of improper payments for laboratory services identified by the Comprehensive Error Rate Testing (CERT) Program were attributable to insufficient documentation. Insufficient documentation means that something was missing from the medical records (e.g., signed physician order, documentation to support intent to order, documentation to […]
FAQs About Medicare Coverage of Chiropractic Services
CMS has addressed more than a dozen of the most frequently asked questions about Medicare coverage of chiropractic services over the years. These questions — and the responses provided by CMS, edited for readability — are as follows: Q: Are there any visit caps or limits for chiropractic services? A: No. There are no caps/limits […]
Insufficient Documentation Triggering Improper Payments for Laparoscopic Hernia Repair
Insufficient documentation has long been understood as a cause of many improper payments for laparoscopic hernia repairs. This was validated a while back when a Comprehensive Error Rate Testing (CERT) contractor conducted a special study of medical billing claims for laparoscopic hernia repairs. When CERT reviews a claim, all lines submitted on the claim undergo […]
Medicare Provides Guidance on Billing for Implantable Automatic Defibrillators
At one time, Centers for Medicare & Medicaid Services (CMS) found that approximately 85% of improper payments relating to the billing of implantable automatic defibrillators were due to insufficient documentation. The figure was determined through a Comprehensive Error Rate Testing (CERT) program’s special study of Healthcare Common Procedure Coding System (HCPCS) code 33249 (Insertion or […]
Medicare Provides Guidance on Proper Coding of Facet Joint Injections
Over the years, Medicare has provided guidance on how to properly code facet joint injections. This education effort largely began after the Medicare Recovery Audit Program identified facet joint injection claims resulting in overpayments. Medicare has noted that it will consider facet joint blocks to be reasonable and necessary for chronic pain (persistent pain for […]
Free Training Course on ICD-10 Diagnosis Codes
The Centers for Medicare & Medicaid Services (CMS) offers a free web-based training (WBT) course on “Diagnosis Coding: Using the ICD-10-CM.” It includes ICD-10 implementation guidance, information on the new ICD-10-CM classification system and coding examples. By the end of the training, CMS indicated participants should be able to: Recognize the ICD-10-CM/PCS implementation date; Identify […]