Author

Elizabeth
Elizabeth works on an array of projects at TCI, researching and writing about modern reimbursement challenges. Since joining TCI in 2017, she has also covered the nuts and bolts of cybersecurity, compliance with federal laws, and how to tap into the advantages of telehealth services.

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    Recoup lost revenue by following up on denials.   After a claim has been properly documented, coded, and submitted for payment, a few things could happen. Hopefully, the insurer pays the claim and the office receives the appropriate reimbursement. But there are other scenarios that could   Read more..
    Posted on 25 Jun, 2018
    By Elizabeth
    Don’t Take Rejections Lying Down
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    In 2003, Medicare established their Fee for Service (FFS) Recovery Audit Program as part of the Medicare Prescription Drug, Improvement, and Modernization Act. Recovery Auditors held a three-year-long demonstration project across six states, between 2005 and 2008, to determine the potential for identifying improper reimbursement   Read more..
    Posted on 21 Jun, 2018
    By Elizabeth
    What You Need to Know About Recovery Audit Contractors (RACs)
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    After an extensive outreach with clinicians, patients, and other stakeholders, CMS tweaked their original strategic objectives to drive progress and improvements. These minor enhancements to the strategic objectives will help guide their final policies and future rule-making in order to design, implement, and advance a Quality   Read more..
    Posted on 18 Jun, 2018
    By Elizabeth
    What You Need to Know About the QPP’s Strategic Objectives
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    In the 2018 Medicare Fee Schedule rule, CMS reviews MACRA patient relationship categories and codes, their development and timelines, and provides details for the initial claims-based reporting of the relationship categories and codes to CMS. These patient relationship categories and codes define and distinguish the   Read more..
    Posted on 13 Jun, 2018
    By Elizabeth
    Conquer Patient Relationship Categories and Codes
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    Telemedicine now allows providers to virtually interact with patients in a way that improves the quality and delivery of care, especially for those patients who are unable to come to the office. The convenience and instant feedback patients receive are among the driving factors behind   Read more..
    Posted on 8 Jun, 2018
    By Elizabeth
    Learn the Criteria Necessary for Medicare’s Telemedicine Services—Part II
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    Medicare pays telehealth services under the Medicare fee-for-service program, with a larger payment made to the consulting physician or practitioner (at the distant site) than the payment made to the facility at the site where the patient is located. According to a MedPAC report, from 2014-2016   Read more..
    Posted on 5 Jun, 2018
    By Elizabeth
    Ace Medicare Telehealth Reimbursement Basics—Part I
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    Do you know? Many federal, state, and private payers report incorrect modifier use as one of the top billing errors — one that results in denials, reductions in payment, or delays in reimbursement. These claims are missing a modifier or they have an incomplete or   Read more..
    Posted on 28 May, 2018
    By Elizabeth
    How to Nail Down These CPT® Modifiers Every Time
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    Separate Evaluation and Management (E/M) Services from the Rest When a provider performs an E/M service and other services including a procedure for the same patient, on the same day, you can code and bill for the procedure and the E/M service separately. You   Read more..
    Posted on 24 May, 2018
    By Elizabeth
    Learn Your Way Around 5 Common Modifiers
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    CMS Administrator Seema Verma recently announced a new initiative designed to improve EHR patient data access called MyHealthEData. Designed to improve EHR patient data access, MyHealthEData is a government-wide initiative led by the White House Office of American Innovation in conjunction with the Department of Health   Read more..
    Posted on 22 May, 2018
    By Elizabeth
    Improving EHR Patient Data Access
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    Like all CPT® codes, E/M codes are universal and used by Medicare, Medicaid, and most other payers for processing claims for a physician’s professional services. You should also use E/M service codes for billing facility services on an outpatient basis. Because evaluation and management services are   Read more..
    Posted on 17 May, 2018
    By Elizabeth
    How to Nail Down Levels of E/M Services & Secure Optimal Reimbursement