Tag: Billing

POET has been asked:

 Author: Seymore Bones  Published Date: July 19, 2022  1 Comment on POET has been asked:

Where is the best place to order Approved 1500 Forms (Better known as HCFA of HICF)?

Please leave a comment below. Thank you.

Sick of Chart Review Request?

 Author: Seymore Bones  Published Date: July 11, 2022  Leave a Comment on Sick of Chart Review Request?

If you are frequently being ask by Cigna MA for chart reviews, click the button below to     find out how to reduce the number of requests you receive.

Click here

AMA unveils anticipated E/M changes for facility-based services

 Author: Seymore Bones  Published Date: July 5, 2022  Leave a Comment on AMA unveils anticipated E/M changes for facility-based services

The AMA set off its own fireworks during the Independence Day weekend with the early release of new E/M guidelines that will be included in the 2023 CPT manual and take effect Jan. 1, 2023

Beginning on that date, the format for office and other outpatient visits (99202-99215) will apply to hospital inpatient and observation visits, consults, and services in the emergency department, nursing facility, home and residence. As a result, history and physical examination will no longer contribute to the level for these visits. Instead, for most visits practices will select codes based on medical decision-making (MDM) or time. The only exception will be emergency department visits, which will be MDM-only because the codes do not have a time component.
 
Among the most radical changes, the AMA plans to delete all observation care codes (99217-99220, 99224-99226) and merge observation services with initial and subsequent hospital care codes (99221-99223, 99231-99233, and 99238-99239)
For the full Article, Click

Cigna Delays Record Request Policy

 Author: Seymore Bones  Published Date: July 5, 2022  Leave a Comment on Cigna Delays Record Request Policy

You may have read the article posted May 23rd. Cigna (Commercial) had implemented a new policy that required medical records be sent when a minor procedure is billed   with an office visit. 

However, Cigna has delayed the Records Request Policy, Staving Off the “Administrative Nightmare” for now. 

Cigna has delayed the implementation of a new billing policy after the Texas Medical Association and others in organized medicine pushed back, warning that it would have negative implications for physicians, practice staff, and patients.

To View This Non-Thriller Article, just click

Invitation to Test New 360 Feature

 Author: Seymore Bones  Published Date: June 6, 2022  Leave a Comment on Invitation to Test New 360 Feature

CIGNAFORHCP.COM MODERATION

You are invited to test the new Claims 360 Feature.

The new Claims 360 feature allows you to:

·        Search for claims using your Tax Identification Number (TIN)

·        Search by claim number

·        Filter and focus on the claims you want to see

For More Information, Click Here.

The Most Asked Questions About Medical Coding Audits Following the 2021 E/M and MDM Changes ~MGMA

 Author: Seymore Bones  Published Date: May 3, 2022  Leave a Comment on The Most Asked Questions About Medical Coding Audits Following the 2021 E/M and MDM Changes ~MGMA
Follow this link for the full Article.

In the above linked article you will find: 

  • What E/M Updates to Watch

  • The definition of “external” for purposes of reviewing data as part of MDM.

  • What is time-based coding?

  •  Documentation Tips

  • And More

Aetna 3rd-Party Claim and Code Review

 Author: Seymore Bones  Published Date: March 10, 2022  Leave a Comment on Aetna 3rd-Party Claim and Code Review

Beginning June 1, 2022, you may see new claim edits.

According to March 1, 2022 Aetna OfficeLink Updates: These are part of our Third-Party Claim and Code Review Program. These edits support our continuing effort to process claims accurately for our commercial, Medicare and Student Health members. You can view these edits on our Availity provider portal.*

You can view any of these edits on Aetna’s Availity® provider portal.

For coding changes, go to:

  • Aetna Payer Space
  • Resources
  • Expanded Claim Edits

Except for Student Health, you’ll also have access to Aetna’s code edit lookup tools. To find out if our new claim edits will apply to your claim, log in to our Availity provider portal. You’ll need to know your Aetna® provider ID number (PIN) to access our code edit lookup tools

To view the Update and see more provider tools, Click

Here is what POET found with 2022 effective dates:

CMS Update: Billing and Coding for Allergy Test

 Author: Seymore Bones  Published Date: March 1, 2022  Leave a Comment on CMS Update: Billing and Coding for Allergy Test
Allergy Testing has been revised, follow this link for the full Article.

Surprise Billing FAQs, MGMA

 Author: Seymore Bones  Published Date: February 15, 2022  Leave a Comment on Surprise Billing FAQs, MGMA

Still confused about Good Faith Estimates (GFE)?

Does Qualifying Payment Amount (QPA) sound like Greek?

Click To View the Surprise Billing FAQs from MGMA

Quarterly Update for Clinical Laboratory Fee Schedule (CLFS)

 Author: Seymore Bones  Published Date: February 7, 2022  Leave a Comment on Quarterly Update for Clinical Laboratory Fee Schedule (CLFS)

Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services Subject to Reasonable Charge Payment

For the MLN Matters Article addressed to physicians, other providers, and suppliers billing Medicare Administrative Contractors (MACs) for services they provide to Medicare patients, click here.
To Download the CLAB 2022 Q1 Fee schedule, click here, then scroll to the bottom of the page and click "Accept".
CLFS