August Bulletin – Billing Mistakes – Part III

BILLING MISTAKES – PART III Coding Ensuring your claims are coded correctly will prevent delays in payments and keeps your account cleaner. Below are common coding errors. Coding is not specific enough Each diagnosis must be coded to the highest level of specificity or insurance carriers may consider the diagnosis truncated. Diagnosis codes can be […]

PAYER ID CHANGES FOR 2021 – JULY BULLETIN

PAYER ID CHANGES FOR 2021 The first half of 2021 has seen a lot of Payer ID and/or claims address changes. Making sure claims are submitted to the correct Payer ID will prevent delays in payments and an increased amount of denials. Below are some payer ID updates to make note of and update. CHAMPVA […]

Billing Mistakes – Part 1 – June Bullein

BILLING MISTAKES – PART I Common Rejections Front-end rejections not only cause a delay in payment, but it adds additional time spent on a single claim. Most rejections can be avoided by making sure all of the required information is obtained and entered into the patient’s chart prior to generating the claim. Identifying some of […]

May Bulletin – INSURANCE UPDATES

INSURANCE UPDATES Several insurance providers have updated their billing guidelines to coincide with the extension of the Public Health Emergency (PHE) period, which is now July 20, 2021. CIGNA The cost-share waiver for COVID-19 testing, screening or diagnostic services will end on the last day of the PHE period. Cigna has also extended accommodations related […]

APRIL BULLETIN – NEW BILLING LAWS SET TO TAKE EFFECT IN 2022

New laws under the No Surprise Act will prevent providers from billing patients more than in-network cost-sharing for out-of-network services and will even establish an arbitration process to resolve unexpected out-of-network charges. The new law take effect January 1, 2022 and applies to nearly all private health plans offered by employers (including grandfathered group health […]

The American Rescue Plan

The American Rescue Plan With the signing of the most recent COVID-19 Relief Bill, more people may be able to afford healthcare coverage through the federal and state health insurance marketplaces. The American Rescue Plan (ARP) will help to save millions of people hundreds of dollars in healthcare insurance costs. Those who qualify include those who […]

March Bulletin – Coding Updates for 2021

Coding Updates – 2021 The continued development of COVID-19 treatments and vaccines has prompted updates in CPT coding and billing guidelines. In addition to the updated E&M code requirements, the American Medical Association developed COVID-19 codes for each of the four coronavirus vaccines and their administrations. 91300: this is for the Pfizer vaccine only. For […]