Category Archives: Billing

Billing and Claim issues

Medicare Fee Schedules for Behavioral Health Providers

The Medicare Fee Schedules for 2018 are ready for Behavioral Health Providers for the following states and locations: Florida     Colorado              Nevada                  Houston Texas   … Continue reading

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Coding by Duration

Recently a clinician told us that providers had been audited for the use of 90837. The CPT codes have a duration associated with them and if the notes and the duration meet the criteria there is no reason for insurance companies to … Continue reading

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Large Deductibles and Co Pay Tips

Large Deductibles can be resolved in a couple ways In our business we get asked how to deal with a client that has a large deductible.  Our responses are listed below. Client can waive usage of their insurance The provider may charge … Continue reading

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PQRS Medicare

Just in case you missed it the latest and last revision to the rules for PQRS are listed below: Major highlights include: Individual eligible professionals and group practices that meet the criteria for 2016 PQRS satisfactory reporting/participation will avoid the … Continue reading

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Medicare Fee Schedules 2016

Medicare Fee Schedules will be available for 2016 by the end of the week.  Be aware that the new deductible for 2016 is 166.00 for Part B.  Place your order now to get one sent to your office.  Information provided … Continue reading

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Fee Schedules

Medicare Regional Reimbursement Schedules are normally made available every year towards the end of January when all the fee issue shake out.  Every year since I have been doing this there is always a change and a rollback on the Medicare fee … Continue reading

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Who’s Who?

Who’s on first?  This is my new saying as I try to work with the different insurances only to find out they have been bought by one entity or another.  Recently I was invited to go to a meeting in … Continue reading

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Transition from ICD9-ICD10

This was in a newsletter from ValueOptions and I believe it responds to an age old question I have received for many years as to why Clinicians are taught in school to diagnose with DSM when the standard for billing … Continue reading

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Co Pays Coinsurance and Deductibles

We are often asked this question about Co pays, Coinsurance and Deductibles.  We must talk on this topic at least 5-10 times a week to one customer or another. 1) Can you charge the client less than the co pay? The answer … Continue reading

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Medicare Deductible FAQ

Q: When is it acceptable to collect the deductible from the beneficiary? A: When assignment is accepted, Medicare Part B recommends: • Since it is difficult to predict when deductible/coinsurance amounts will be applicable – and over-collection is considered program … Continue reading

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