CMS Announces New Place of Service Code Effective January 1, 2022, a new place of service (POS) code became effective for use. The new POS Code, 10, indicates Telehealth services provided in the patient’s home. Prior to the creation of POS 10, the correct place of service code for all Telehealth visits was 2. Now, […]
March Bulletin – Insurance Company Updates
Insurance Company Updates Several insurance companies have made note-worthy updates to their billing policies. Superior HealthPlan Effective June 1, 2022, the criteria for the assessment and treatment of Attention Deficit Hyperactivity Disorder (ADHD) has been revised and updated. More than a dozen CPT codes have been deemed not medically necessary when billed with a sole […]
February Bulletin – The “No Surprise Act” Causes Confusion
Since the No Surprise Act (NSA) became effective on January 1, 2022, medical offices are experiencing trouble understanding and implanting the new requirements to remain compliant with the NSA guidelines. On January 20, 2022, the Medical Group Management Association (MGMA) called on the Centers for Medicare and Medicaid Services (CMS) and the US Department of […]
January Bulletin – Billing Reminders for the New Year
Billing Reminders for the New Year Eligibility & Benefits With a new year comes new insurance policies for patients across the nation. It is important to remember that many plans change at the start of a new year so verifying benefits and eligibility is key to proper billing. While some patients keep the same insurance […]
December Bulletin – CMS Billing Updates for 2022
CMS Billing Updates for 2022 Premiums, Deductibles & Coinsurance Changes In November, the Centers for Medicare & Medicaid Services (CMS) released the 2022 premiums, deductibles and coinsurance amounts for Medicare Part A and Part B. Each year to determine the Medicare Part B premiums, deductibles and coinsurance amounts, the Social Security Act is used and […]
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 […]