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Spruce up insurance verification to speed processing, prevent post-encounter billing

09/18/2017

With Medicare open enrollment starting Oct. 15 and Obamacare open enrollment starting Nov. 1, it’s a good time to tighten up your insurance verification by using tech tools and alternative patient interview options.

Watch new bundled codes impacting critical care, drug screening, obesity counseling

09/18/2017

by: Richard Scott and Laura Evans

Take stock of the latest code bundles from CMS in the Correct Coding Initiative version 23.3 update — you’ll find new edits affecting how to bill critical care services in the emergency department, drug-testing codes, obesity counseling and more.

Look to law if payer’s recoupment process is flawed

09/18/2017

by: Roy Edroso

If a payer is threatening to recoup alleged overpayments and doesn’t have an appeals process (or has only a shell of one), make sure you get the protection to which you’re entitled — and use state or federal law to get them to pay attention.

CCI version 23.3 scorecard: Watch out for 1,500 new code pairs

09/18/2017

by: Richard Scott

Find out which code ranges are subject to the Correct Coding Initiative (CCI) version 23.3 edits, which go into effect Oct. 1. The latest edits add 1,534 new code pairs, delete 18 pairs and apply medically unlikely edits (MUEs) to 181 services.

Sanders unveils single payer Senate bill

09/18/2017

by: Roy Edroso

On September 13 on Capitol Hill in Washington, Senator Bernie Sanders (I.-Vt.) announced that he would put a “Medicare for All Act of 2017” single payer health care bill before the Senate.

Some soon-to-be-bundled eye exam codes easily accepted — a few, much less so

09/18/2017

by: Roy Edroso

Of the six eye exam codes eye that will be bundled in new CCI code pairs, four had relatively stable denial rates between 2011 and 2015 — but two of them had remarkably high and much less stable denial rates.

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