Posts Tagged ‘Los Angeles’
Senate Bill 1160, Workers’ Comp, Automatic Authorization and You
Senate Bill 1160 was passed by the California legislature in 2016 in a wide-ranging effort to reform the state’s Workers’ Comp billing system. It included changes to automatic authorization, utilization review, lien filing, billing deadlines and much more. While most of the changes took effect in 2017, some did not start until January 1st, 2018.…
Read MoreMedically Unlikely Edits and CPT Code 97750
Medical billing for physical performance testing is an area where many doctors get frustrated due to claim denials. This is usually because of coding errors and misunderstandings around the “eight-minute rule” and MUEs. Current Procedural Terminology (CPT) Code 97750 is the procedure code to bill for functional capacity exams, including physical performance tests and measurements,…
Read MoreHand it Over! Four Reasons to Outsource to a Medical Billing Service
By outsourcing your revenue cycle management to a reputable and experienced medical billing service, you gain access to expert resources, methodology, and state of the art technology that come only with specialization and scale. Here are four ways we can save you time and money: Staying up to date on CPT codes The sheer volume…
Read MoreDWC Posts Fee Schedule Adjustments for Hospital Outpatient Departments/Ambulatory Surgical Centers
It is our passion to help physicians stay on top of the latest changes in workers’ comp billing legislation. If you have any questions about the changes to the Medicare payment system below, please feel free to call us–we’d love to talk to you. Who knows? It might be time for you to switch to…
Read MoreABNs- Creating Doctor-Patient Trust AND Ensuring Doctors Get Reimbursed
Medical billing may not seem like an obvious area for improving doctor-patient relations, but being upfront with your patients about what services Medicare will and won’t cover can build trust between the patient and the doctor. “Patients may not like what they hear,” according to Orthopedic Coding Alert Magazine, but informing patients that a service…
Read MoreDWC Posts Adjustments to Official Medical Fee Schedule
This is what we live for! At the end of March, the Division of Workers’ Compensation (DWC) posted an order adjusting the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system. And your workers’ comp billing and CPT codes need to adjust accordingly. The easiest solution? Outsource your medical billing…
Read MoreAnthem’s Evaluation and Management Services Medical Billing Reimbursement Policy
The constant changes to policies regarding medical billing, CPT codes (Current Procedural Terminology), and modifiers can make your head spin. As if it weren’t complicated enough determining whether an E/M visit code (evaluation and management) can be applied to a service provided by the same provider on the same day as a minor surgery, Anthem…
Read MoreEnormous Victory for the Qualified Medical Examiners (QMEs) of California
The Division of Workers’ Compensation will now allow the Qualified Medical Evaluators QMEs to cite medical causation as a complexity factor on accepted claims; allow them to bill for medical research that is within their scope of practice and it will allow them to charge for time spent preparing reports when using the ML 104…
Read MoreNew Medicare Cards Rolling out now – the MBI and Your Practice
The Centers for Medicare & Medicaid Services (CMS) are removing Social Security Numbers from Medicare cards to prevent fraud, fight identity theft, and keep taxpayer dollars safe. CMS has started mailing newly-designed Medicare cards with the new Medicare Beneficiary Identifier (MBI), or Medicare Number. People enrolling in Medicare for the first time will be among…
Read MoreThe Hidden Payoff in Labor Code LC 5402
One simple question can mean the difference between getting paid on a workers’ compensation claim or not. Under LC 5402, when attempting authorization on a workers’ comp claim, always ask if the claim/case is accepted, denied or still in discovery. If the insurance company has not decided to accept or deny the claim then provider…
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