medical billing services

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Provisional Prior Authorization from Medicaid- Three State Approach

https://www.medicalbillersandcoders.com

Beneficiaries who are dually eligible for Medicare and Medicaid often experience difficulties accessing durable medical equipment (DME), such as wheelchairs, in a timely manner. Whether Medicare or Medicaid covers a specific item may be unclear.

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Using Correct Combinations – Modifier 50

https://www.medicalbillersandcoders.com

When modifier 50 is included in the medical claim, it can render certain other modifiers invalid (such as 26, LT, RT, and TC). Modifier 50 is only added to a medical procedure when that particular procedure is completed bilaterally, or on both sides.  Modifiers LT and RT refer to a procedure completed on only the left or right sides.

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Created by alexpetermbc 7 weeks 3 days ago – Made popular 7 weeks 3 days ago
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Reimbursement Guidelines for Modifier 90

https://www.medicalbillersandcoders.com

Modifier 90 is used by a physician or clinic when the laboratory tests performed for a patient are performed by an outside or reference laboratory. This modifier is used to indicate that although the physician is reporting the performance of a laboratory test, the actual testing component was a service from a laboratory.

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How To Prevent Medical Billing Claim Denials?

https://thehomosapienhuman.blogspot.com

outsource medical billing - It's a well-known fact that the relationship between health care providers and insurance companies is not simple. Healthcare providers often spend a significant amount of their time and energy with their patients to find out if an insurance company will fight them on paying for the services provided.

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Created by justcaretech 9 weeks 2 days ago – Made popular 9 weeks 2 days ago
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Proper Use of Modifier 59 after NCCI Update

https://www.medicalbillersandcoders.com

There is an appropriate use for modifier 59 that is applicable only to codes for which the unit of service is a measure of time (e.g., per 15 minutes, per hour).

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Use the Medicare National Correct Coding Initiative (NCCI) Tools

https://www.medicalbillersandcoders.com

The Medicare National Correct Coding Initiative (NCCI) (also known as CCI) was implemented to promote national correct coding methodologies and to control improper coding leading to inappropriate payment.

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Medicare Proposed Changes for 2020 Physician Fee Schedule

https://www.medicalbillersandcoders.com

The changes for CPT also change the medical decision-making process for the codes, while requiring the performance of history and exam only as medically appropriate. CPT code changes also allow clinicians to choose the E/M visit level based on either medical decision-making or time involved.

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Patients over Paperwork – CMS’s Approach to improve Patient Care

https://www.medicalbillersandcoders.com

The Omnibus Burden Reduction (Conditions of Participation) Final Rule strengthens patient safety by removing unnecessary, obsolete, or excessively burdensome health regulations on hospitals and other healthcare providers.

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AMA Announces 2021 E/M Changes

https://www.medicalbillersandcoders.com

Medicare has published the 2021 E/M changes they intend to make and now, so has the AMA. We’ve all seen that when Medicare and CPT do not agree on the way in which a specific service, or group of services, should be reported, Medicare may produce HCPCS code(s) with specific guidance for Medicare contracted providers to follow.

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Basic Guidelines for Accurate Diagnosis Coding

https://www.medicalbillersandcoders.com

Medical coders are responsible for ensuring proper diagnosis coding for each procedure billed to an insurance company. Although most claims billers do not actually code diagnosis, they are often responsible for choosing the correct code for each claim. This article provides tips for accurate coding as well as information regarding diagnosis codes on claims.

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