In Billing
Jul 30th, 2018
Medicare claims that do not meet date format requirements will be rejected. The Centers for Medicare & Medicaid Services (CMS) has released date formatting guidelines for the CMS-1500 claim form, which are effective for claims received on or after July 30. When date formatting requirements are not met, Medicare Administrative Contractors will return claims as “unprocessable” with t...
In Billing
Jul 26th, 2018
The long-awaited 2019 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule, released July 25, sets the wheels in motion for significant reforms in the way Medicare will pay providers in hospital outpatient settings. The Centers for Medicare & Medicaid Services (CMS) is moving toward site-neutral payments for clinic visits, which will save ...
Overcome billing challenges with processes that pave the way to a healthy revenue cycle. Federally qualified healthcare centers (FQHCs) are taking on a more prominent role in our healthcare system, providing primary care, as well as multi-specialty services including obstetrics/gynecology (OB-GYN), mental health, vision, and dental services. Because of the wide array of services provided ...
In Billing
Jun 25th, 2018
Clearing houses affect revenue flow through denials. Understanding them and their processes helps you speed your re-submissions. After a claim file is sent to the clearinghouse, an edit report is sent back to the practice, indicating claims and charge lines rejected with various edit problems. If the details in these edit reports are not attended ...
In Billing
Jun 21st, 2018
The Centers for Medicare & Medicaid Services (CMS) is modifying its Medicare coverage policy for continuous glucose monitors (CGMs) to support their use in conjunction with smartphones, including the data sharing function CGMs provide. Medicare coverage of therapeutic CGMs began in January 2017, but the policy limited their use in conjunction with smartphones. CMS is removing this limitation in...