The COVID-19 Delta Variant The SARS-CoV-2 B.1.617.2 (Delta) variant was discovered in India in late 2020 and it has since become the dominant strain in the United States. The Delta Variant is More Contagious The World Health Organization (WHO) has called the Delta Variant the “fastest and fittest” strain. The Centers for Disease Control 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 […]
BILLING MISTAKES – PART II – JULY BULLETIN
Incorrect Insurance It is important to ensure all of the correct information is on the claim to prevent delays in payments. Making sure the correct and up to date insurance is obtained can prevent a number of denials and rejections; both of which cause a delay in payment. 1. Is The Plan Active? Verifying eligibility […]
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 […]
COVID-19 VIRUS UPDATE – June Bulletin
Delta Variant In December 2020, a new COVID-19 variant was found in India. Now, as of June 2021, just six months after the discovery of the Delta Variant, it is the dominant strain in both India and the United Kingdom. Some key factors to know about the delta variant, also known as B1617.2, are the […]
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 […]
APRIL BULLETIN – AN IN DEPTH LOOK AT THE NEW 2021 E&M CODING GUIDELINES
As of January 1, 2021, the American Medical Association and the Centers for Medicare and Medicaid Services implemented changes to evaluation and management services. The changes are meant to decrease the amount of required documentation and increase the amount of time spent with patients. The E&M codes affected are 99201-99215 and all other E&M codes […]
March Bulletin – COVID-19 Vaccination Update
COVID-19 VACCINATION UPDATE As of February 27, 2021, four COVID-19 vaccines have been approved for emergency use and have all been issued CPT codes (please see “Coding Update – 2021” on the PGM Blog for CPT codes and NDC numbers). On March 3, 2010 the Centers for Medicare and Medicaid Services (CMS) released the […]