Patient Eligibility and Benefits The medical insurance landscape is changing and the need to verify patient eligibility and benefits has never been more critical to the financial success of your practice. It is estimated that the patient’s financial responsibility has increased from 10% to 30% since the Affordable Care Act has been enacted. On top […]
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Here is a great video on the multitude of issues as to why it takes so long for your claims to be paid. Unfortunately, it is a conversation we have far too often with many patients who just do not understand how the process works. We can definitely relate to many of the issues that
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Modifier 59 Misconceptions There are many misconceptions about the proper use of Modifier 59. Medicare tracks the use of Modifier 59 and ranks practices based on their use of this modifier to select practices to audit for misuse of Modifier 59. The Medicare National Correct Coding Initiative (NCCI) includes Procedure-to-Procedure (PTP) edits that define when
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Plan of Care Requirements The Centers for Medicare & Medicaid Services (CMS) is continuing to focus on lowering the Comprehensive Error Rate Testing (CERT) claims paid error rate and one area of concern is missing physician/non-physician practitioner signature and dates on the certification of the plan of care. After analyzing the CERT data, denial of
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