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 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 […]
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 […]
January 2023 Bulletin: Billing Reminders Part 2: Secondary Payers
Billing Reminders for the New Year – Part 2 Medicare Secondary Payer: Sometimes, a member will have Medicare as a secondary payer. In this case, it is mandatory that the Medicare Secondary Payer (MSP) code be entered on the claim form. This can be found on Availity or the Medicare web portal. Common MSP codes […]
January 2023 Bulletin: Billing Reminders Part 1 – Eligibility & Benefits
Billing Reminders for the New Year – Part 1 Eligibility & Benefits: With a new year comes new insurance policies for patients across the country. It is important to remember that many patients change plans at the start of a new year so verifying benefits and eligibility is a must. While some patients keep the […]
December 2022 Bulletin – COVID-19 Vaccine Updates
COVID-19 Vaccine Updates The holiday season has the potential to bring a new wave of COVID-19, so understanding what vaccines are right for you is vital to keep you and your family members safe. As of December 22, 2022, the Centers for Disease Control and Prevention (CDC) provided updates on what you need to know […]
December 2022 Bulletin – It’s Deductible Season!
It’s Deductible Season! The end of one year brings the beginning of a new one and that means annual deductibles have been reset for 2023. As a result, patients will be responsible for higher balances and insurance payments will be lower for the first quarter of the year. To better understand what a patient may […]
November Bulletin – Medicare Part B & Tetanus Vaccines
Medicare Part B & Tetanus Vaccines Did you know that Medicare Part B only covers a tetanus vaccine when it’s given as the result of an injury or direct exposure? Medicare Part B does not cover tetanus vaccines when given preventatively. In fact, Medicare Part B doesn’t cover most preventative vaccines, so coding is important […]