Tag: Billing
THRIVE
THRIVE CareAllies’ Provider Newsletter May 2021
Education inside: Obtain Assistance with Coding Accuracy and Documentation, one-on-one education, coding reference tools. Get set up for remote access, email [email protected].
Resource Material inside:
- CoVid Vaccine Flyers
- Call us first: Poster, Wallet Card, Wearable Button, etc.
- NO-SHOW: Poster and Wallet Card (customizable)
Email CareAllies at [email protected] with any topic suggestions for this (your) newsletter.
BCBS UPDATE 5/12/2021
SA Modifier and Midlevel Provider Contracting Update.
On January 19, 2021, Blue Cross and Blue Shield of Texas (BCBSTX) posted an article regarding contracting and credentialing midlevel providers and the upcoming implementation of the ClaimsXtenTM edit of the SA modifier for non-payable services resulting in the SA modifier being non-reimbursable. This edit has not been implemented and there are currently no plans for future implementation of this edit.
SA Modifier Reminder
The SA modifier should be used:
- By the supervising physician, when he/she is billing for services rendered by a Physician Assistant (PA), Advanced Practice Nurse (APN), Certified Registered Nurse First Assistant (CRNFA) or Licensed Surgical Assistant (LSA).
- On claims submissions by PA or APN’s when billing under their own NPI number for assisting with any other non-surgical procedures.
This information can be found in the Clinical Payment and Coding Policies – Modifier Reference Guideline located on the provider website. Information about the reimbursement amount for the SA modifier is available in the Reimbursement Schedules and Related Information (Secure Content) area of the General Reimbursement information page. You will need a password to access this information which can be obtained from your local Network Management Office location.
E&M Coding in 2021
Now is the time to take a few minutes to assess your coding.
- If you are coding close to your specialty’s bell curve and if your documentation supports your coding, take a deep breath. If you find you are an outlier, don’t panic. Time is on your side.
- Under-coders of the world, look to increase your coding. Your documentation likely supports a higher code. Over-coders, make sure your documentation supports your higher coding.
- You are at higher risk for an audit, and your best defense will be solid documentation
Are you curious to see how you are doing? Follow this link to “Physicians Practice” article:
E&M Coding in 2021: Four Questions, Four Answers
COVID-19 news from UnitedHealthcare, April 20th, 2021
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News from UHC
UnitedHealthcare remains committed to delivering timely news and updates to help you stay informed of fast-changing COVID-19 circumstances. Here’s a quick overview of the recent extension of the national public health emergency period, as well as billing updates and resources to help you answer patient questions about COVID-19 vaccines. For the complete article follow this link to the InK Files.
Check Those Checks!!!
- Don’t get caught in this dirty deal.
- Know what you are endorsing.
- If you receive payment with no patient information this should be a red flag.
- By endorsing you could be agreeing to accept whatever payment they wish to send.
- Your endorsement could also serve as an authorized signature for contract.
6 Keys to Addressing Denials
6 keys to addressing denials in your medical practice’s revenue cycle
MGMA STAT – MARCH 18, 2021
The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “Has your organization seen denials increase in 2021?”
- 69% said “yes.”
- 31% said “no.”
Common responses from respondents included payers not reimbursing for codes related to COVID-19 supplies, critical care claims and imaging CTs.
For those healthcare leaders who reported an increase in denials, the average increase in denials was 17%.
- Half responded that they increased by 1% to 10%.
- 34% said 11% to 20%.
- 12% who stated 21% to 30%.
The poll was conducted March 16, 2021, with 576 applicable responses.
For great tips and strategies to use, follow this link or visit “The Business End” folder located in the InK files.
6 Keys to Addressing Denials in Your Medical Practice’s Revenue Cycle, MGMA STAT – March 18, 2021
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Reimbursement Policy Update Bulletin: UHC March 2021
UHC releases revised reimbursement policies for: Outpatient Hospital, Laboratory Services and Emergency Department E/M.
Vaccine Billing and Coding Reference, MGMA 2021
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