Part B News
Care delays, staff burden: PA process still rankles, worries
03/21/2022
by: Richard Scott
The long-standing challenge of the prior authorization (PA) process, which providers have cited as an impediment to care for years, has not become easier to navigate and still puts patients at harm, industry surveys indicate.
Sharpen your billing after MACs warn practices to clean up incident to
03/14/2022
by: Julia Kyles, CPC
A $900,000 settlement and a Medicare administrative contractor’s (MAC) call to perform internal reviews are the latest reminders that incident-to billing remains a challenge. Failure to stay compliant can erase the additional revenue a practice might earn from billing a non-physician’s service under a physician’s name.
With fraud rising, get proactive to counter embezzlement schemes
03/14/2022
by: Roy Edroso
A recent string of embezzlement cases underscores the danger this type of fraud poses to practices and health systems, even those with well-funded financial management programs. Don’t rely on the usual audit processes to catch potential embezzlement activity; instead, you should actively monitor for and deter it.
Hone in on CPT coding for subsequent hospital care and discharge services
03/14/2022
by: Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC
Selecting the appropriate subsequent care code can be daunting as CPT codes 99231-99233 are similar and coding is based, unlike office visits, on the documentation of two of three key components. Sharpen your coding prowess by navigating the differences between the coding and documentation requirements.
Aetna closes the door on office consults
03/14/2022
by: Julia Kyles, CPC
On March 1, Aetna joined the long list of private payers that have cut coverage of office consults (99241-99245).
Transitional care management hit a COVID wall, but denials dropped too
03/14/2022
by: Roy Edroso
While many phone and online services jumped in 2020, transitional care management (TCM) hit a huge snag in utilization. However, despite the lower number of claims, providers had less trouble than ever getting their claims accepted.
Direct primary care, excising the middlemen, paves a novel way
03/07/2022
by: Roy Edroso
Primary care providers and group practices tired of the insurance bureaucracy can consider a shift into direct primary care (DPC), but they should know that the freedom from health plan pressure comes with extra responsibilities.
Complexity of problems addressed: Communicate to clear confusion in MDM table
03/07/2022
by: Julia Kyles, CPC
Add an emerging body of official guidance about the “number and complexity of problems addressed” element of medical decision-making (MDM) to your next training session on E/M office visits (99202-99215). It will bolster your coding and billing efforts.
Court blocks baseline fee determination in No Surprises regs
03/07/2022
by: Roy Edroso
A Texas court vacated one feature of the independent dispute resolution (IDR) process outlined in the federal government’s No Surprise Act regulations, a decision that may result in more providers challenging prices named by the government — and cause them to go up.
Noridian allows multiple same-day E/M visits for multispecialty NPPs
03/07/2022
by: Julia Kyles
Noridian has created a way to recognize — and reimburse — nurse practitioners (NP) and physician associates (PA) who provide specialty care for a multispecialty group.
Prev Next

Login

User Name:
Password:
Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Quick Links
Learning Opportunities
See more...
Forum

The Forum is temporarily unavailable.

click icon to expand
Back to top
Privacy Policy
|
Terms of Use
|
© 2025 DecisionHealth, an HCPro Brand