Medical Billing Coding Webinars
Avoid Common Rejections And Errors With 855 Form Submissions
The Centers for Medicare & Medicaid Services (CMS) are taking steps to improve oversight of the Medicare program. They've recently updated enrollment regulations and policies, aiming for greater transparency and accountability. Key changes include updates to Medicare provider and supplier enroll...View More
CMS Final Rule on Medicaid and CHIP Eligibility, Enrollment, and Renewal
The Centers for Medicare & Medicaid Services (CMS) recently issued Final Rules outlining the changes, updates, or clarifications to the Medicaid and Children's Health Insurance Program (CHIP) regulations. These rules typically address various aspects of these programs, including eligibility, enr...View More
CMS Guidelines for Wound Care Medical Billing and Coding 2024
Wound care management is integral to the healthcare system, necessitating meticulous attention to medical billing and coding protocols. The Centers for Medicare & Medicaid Services (CMS) offer comprehensive guidelines to ensure precise reimbursement for wound care services. So, healthcare profession...View More
Encounter for Medication Refill ICD-10
When a new year starts, coding professionals usually worry about the coding changes that come with it. Whether you're a professional coder or just wondering how to grapple with the upcoming updates, it's the right page to read. In this article, we will highlight some significant ICD-10 codin...View More
Enhancing Denial Management Processes with AI
Artificial Intelligence has become a game changer in various industries, and from last year's emergence, it has found its way into healthcare. However, the healthcare industry has been tackling several challenges, including medical coding and billing intricacies, workforce shortage, and more. Cl...View More
AI Powering Precision - Main Role of Artificial Intelligence in CMS Prior Authorization
In October 2023, the president decided on some rules for how artificial intelligence (AI) can be used in healthcare. This is important because AI can be a powerful tool, but we want to make sure it's used safely. Part of these rules focus on using AI responsibly in healthcare. This means making ...View More
Top 5 Best Practices For Complete Documentation Of Injections And Infusions
Administering injections and infusions entails numerous complexities owing to the extensive CPT instructional notes, hierarchical regulations, and varying payer directives. Leveraging outsourced medical billing can mitigate the challenges surrounding the reporting of drug administration services. He...View More
Top 5 Tips for Prior Authorization Success in Healthcare
Prior authorization, also known as precertification, predetermination, and pre-approval, is a health plan cost-control process in which healthcare providers such as hospitals or physicians obtain advance approval from the insurance plan to qualify the payment coverage for a specific treatment or ser...View More
Medicare Payments 2024 and Medicare Charges for 2024
Healthcare is one of the vast industries that revolves around many changes. Many changes are coming to medicare payments in 2024. CMS (Centers for Medicare & Medicaid Services) unveiled changes on 12 October 2023 related to premium, deductible, and coinsurance details for the Medicare Part A and Par...View More
Unveiling the Secrets of Shared Care and Incident To Billing in 2024
As the pages of 2023 turn and the new year arrives, healthcare compliance bodies are also ready to introduce many other changes. Current CMS changes to their shared care policy have added to the confusion for physicians and other professionals. Hence, it's imperative to understand the incident t...View More
Impact of the CMS Physician Final Rules on Physician Reimbursement
The Centers for Medicare and Medicaid Services (CMS) has reduced a certain amount in the conversion factor (CF), dropping the rate from $34.61 to $33.06. This change represents a $1.55 decrease compared to the 2022 rate. The finalization of this rule has sparked concern among numerous providers due ...View More
Provider Enrollment vs Credentialing What is the Difference
If you are confused between provider enrollment and credentialing, you have landed on the right platform. However, both are vital processes in the healthcare industry and are crucial for building a successful provider enrollment program. This piece of work will help you navigate the key difference b...View More
CMS Finalizes Medicare Rates, Policies, and Hospital Payment Rates for 2024: What You Need to Know
The Centers for Medicare & Medicaid Services (CMS) issued the final rule on August 1, 2023, for the fiscal year (FY) 2024 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS). As a healthcare associate, it’s crucial to be a...View More
What Covers in Preventive Medicare Services
The government designs the medicare program for older people with disabilities who turn 65. You can enroll in the program three months before your milestone birthday and continue for a maximum of three months following. You'll be registered in Medicare by default if you get Social Security benef...View More
Provider Credentialing What You Need to Know
The healthcare profession is one of the trusted occupations after the pandemic or before that, and it's because of the trusted systems in the healthcare industry. However, ensuring the competence and reliability of healthcare providers is paramount. This is where provider credentialing, often ca...View More
Innovative Payment Approaches for Methadone Treatment
Behavioral health services covered by Medicare, which are services related to mental health and substance use, can significantly impact a person's overall well-being. It's important to know what CMS Physician Proposed Rule 2024 is.
Methadone is an FDA-approved medication for treating Opio...View More
Navigating The 2023 CMS Physician Fee Schedule, Look Up
The final 2023 Medicare Physician Fee Schedule (MPFS) has released by the Centers for Medicare and Medicaid Services (CMS) on November 1. 2022. It included the upgradation of key factors such as Medicare payment and quality provision. This proposal has reduced the fee schedule conversion factor from...View More
Streamlining the Medicare Enrollment Process: 2023 Updates to the Medicare 855 Form
Medicare is a federal health insurance program that provides coverage to people over the age of 65, as well as those with certain disabilities. To enroll in Medicare as a healthcare provider, you must complete the Medicare 855 enrollment form. This form is used to gather information about your pract...View More
Navigating the 2023 CPT, ICD-10, and Payer Changes
The Current Procedural Terminology (CPT) code set is a medical coding system used to report medical, surgical, and diagnostic procedures and services. The International Classification of Diseases, 10th Edition (ICD-10) is a medical coding system that is used to report diagnoses and other health-rela...View More
How to Avoid Medical Claim Denials and Increase Revenue Fast?
In any medical role, insurance denials can be unexceptionally found. Inadequate handling of insurance denials impacts the billing team as in whole. In 2022, new ways to avoid claim denials and postpone payments are continuously surfaced by insurance payers. It should not as a surprise that the medic...View More
Social Media and HIPAA Everything You Need to Know
HIPAA came into existence long before social media appeared on the scenes of digitalization. Yet, HIPAA isn’t unaware of the security measures that need to be taken to ensure the safety of both the patient and the hospital facilities.
However, there is no denying the plenty of offerings or the ...View More