Jul 22, 2015 | Medical billing basics
What services are included in the global surgery payment? When the physician who furnishes the surgery also furnishes the following services, Medicare includes them in the global surgery payment: •Pre-operative visits after the decision is made to operate. For major...
Jul 10, 2015 | Medical billing basics
Definition of a Global Surgical Package This fact sheet is designed to provide education on the components of a global surgery package. It includes information about billing and payment rules for surgeries, endoscopies, and global surgical packages that are split...
Jul 5, 2015 | Medical billing basics
CMS Resources Website Versions 5010 and D.0 This website contains background, regulatory, educational, and implementation information. Versions 5010 and D.0 This website contains background, regulatory, educational, and implementation information....
Jun 26, 2015 | Medical billing basics
• Abdominal Aortic Aneurysm Screening • Alcohol Misuse Screening and Behavioral counseling Intervention in Primary Care • Annual Wellness Visit (Including Personalized Prevention Plan Services) • ...
Jun 18, 2015 | Medical billing basics
Denial reason code CO/PR B7 We received a denial with claim adjustment reason code (CARC) CO/PR B7. What steps can we take to avoid this denial? Provider was not certified/eligible to be paid for this procedure/service on this date of service. You received this...
Jun 8, 2015 | Medical billing basics
Physician play a key role in documenting eligibility and medical necessity for home health care for Medicare beneficiaries. If you certify the need for home health care for any of your patients, we encourage you to review this article carefully. As a physician, you...
Jun 3, 2015 | Medical billing basics
Modifications to Meaningful Use for 2015 through 2017: Realigning the EHR Incentive Programs to support health information exchange and quality improvement On April 10, 2015, the Centers for Medicare & Medicaid Services issued a new proposed rule for the...
May 18, 2015 | Medical billing basics
How do you determine whether prescription drug coverage is creditable coverage? Prescription drug coverage is creditable if the actuarial value of the prescription drug coverage offered by the entity equals or exceeds the actuarial value of the standard prescription...
May 6, 2015 | Medical billing basics
Novitas Solutions Medical Review (MR) Department has observed a continued trend of the utilization of non-physician practitioners to perform initial office visits as “incident to” services. Documentation reviewed by the MR Department indicates that a...
Apr 29, 2015 | Medical billing basics
Crossover Crossover is an automatic claim filing service used by Railroad Medicare and Medicare Part B contractors to send claim information to your supplemental insurance after Palmetto GBA has processed a Medicare claim for you. This saves you the time of...
