Keeping Up with CMS Policies on Medicare Cards and Flu Vaccine Reimbursements

New Medicare Card Transition Period Ends December 31, 2019 As a result of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), in 2018 the Centers for Medicare and Medicaid Services (CMS) began issuing new Medicare cards to all beneficiaries; unlike the previously existing cards, the new cards do not display the beneficiary’s Social Security number. CMS set up a schedule to mail out the new cards based on regions, to be completed by April 2019. The project is now complete and all Medicare beneficiaries should have received their …
Read More

Be Ready for the ICD-10-CM 2020 Updates

October 1, 2019 introduces 273 new diagnosis codes, 21 deactivated codes, and 35 code description revisions to the International Classification of Diseases, 10th Revision, Clinical Modification set, bringing the total ICD-10-CM code count to 72,184. The following describes those that are most relevant to the urgent care provider. Chapter 8: Diseases of the Ear and Mastoid Process (H60-H95) There is just a small change to note here, where code H81.4, “Vertigo of central origin” was added to replace expired codes H81.41, H81.42, H81.43, and H81.49. This change removes the laterality …
Read More

Utilizing Credit Card Pre-authorization to Optimize Revenue

With the continued rise of the cost of healthcare and higher out-of-pocket costs to the patient, urgent care centers are finding more patients struggling to pay their deductible. The process of billing patients for deductibles and other patient responsibility can be a long, drawn out procedure resulting in significant costs, delays, write-offs and slower collection time for the urgent care center. The traditional method of sending out patient statements and waiting and hoping for patients to pay is costly and inefficient. Contacting insurance companies prior to the patient visit to …
Read More

Optimize Revenue with Improved Claims Denials Management

No matter how diligent your billing staff is about billing charges out correctly, it is inevitable that you will receive claim denials from payers, whether they are justified or not. A claim denial means that no payment is being received for the service, and unless you have someone (or technology) analyze the denial to determine if the denial is appropriate or not, you will not receive payment for the service(s) rendered . Denials come in different forms and can typically be classified into one of the following types and examples: …
Read More

Get Ready for the Next Round of Changes to E/M Guidelines

The American Medical Association has announced it is taking the first steps towards revising the new Evaluation and Management (E/M) guidelines that the Centers for Medicare and Medicaid Services (CMS) introduced last year to reduce the administrative burden on clinicians with the Patients over Paperwork initiative.1 Effective as early as January 1, 2021, office visit Level 1 E/M code 99201 will be deleted. Additionally, while the history and exam will be required to be reviewed by the provider, they will not be scored as key components for selecting an E/M …
Read More
Loading...