Reimbursement and Coding

IRS Could Cut Physician Medicare Income Starting in 2012
The Internal Revenue Service (IRS) could withhold 3 percent of physicians’ Medicare payments beginning in 2012.

How to Bill for Preoperative Histories and Physicals Members Only Document

Find out when you can bill for preoperative histories and physicals and then take a quiz to test your knowledge.

United to Require Outpatient Imaging Preauthorization
Most physicians will need preauthorization from United Healthcare for outpatient advanced imaging procedures.

United Healthcare to Reprocess Some Denied Obstetrical Claims
United Healthcare will automatically reprocess these claims. Physicians do not need to appeal or refile their denied claims.

Join Network to Provide Care for Refugees
Physicians interested in providing care for refugees can join the Pennsylvania Refugee Health Program provider network.

Pennsylvania E&M Reimbursement Lower Than Many Nearby States
Pennsylvania’s average evaluation and management (E&M) code reimbursement is lower than many other states in the region, according to a report from the Pennsylvania Medical Society.

Highmark Medicare Services Clears Up Consultation Code Confusion Members Only Document

Highmark Medicare Services offers a review of Medicare consultation coding changes.

Workers' Compensation Fees Increased for 2010 Members Only Document

The workers' compensation Part B fee schedule increased in 2010.

IBC to Increase Reimbursement for Primary Care
Independence Blue Cross (IBC) will increase reimbursement for primary care physicians beginning July 1, 2010.

Medicare Eliminates Consultation Codes
The Centers for Medicare and Medicaid Services (CMS) has eliminated most existing consultation CPT and HCPCS codes for Medicare Part B.

New Online Tool Can Help You Fight Claim Denials
Use this free tool to fight electronic claim denials.

Medical Society Lobbies for Medicaid Increase
Medicaid has announced changes to its fee schedule, including a major increase in allergen immunotherapy reimbursement.

Medicaid Won't Reimburse Hospitals for Preventable Serious Complications
Medicaid will not reimburse hospitals for preventable serious complications—or “serious adverse events."

Making the Health Plan Participation Decision
Medical practices should exercise caution when deciding which health plans they’ll participate in.

Collection Protocols for the Medical Practice
Manage your accounts receivable and prevent them from becoming delinquent. “Collection Protocols” includes tips on managing accounts and also useful collection techniques.

Workers' Compensation: The Application for Fee Review Process
A Workers' Compensation (WC) insurance carrier has 30 days to pay your bill, deny the worker's claim for benefits, or request a utilization review. If your payment is late or incorrect, file for fee review.

Act 6: A Crash Course in Auto Accident Reimbursement
A concise run-down of the steps you need to take to get appropriately reimbursed for care of patients injured in a motor vehicle accident.

Your Right to Timely Payment Under Act 68
Act 68 requires health insurers to remit payment for clean claims within 45 days of receipt.

Billing Tactics to Maximize Revenue
Improve your practice's cash flow by implementing 10 tactics to maximize revenue.

Beware of Automatic Participation Clauses in Payer Contracts Members Only Document

Don't be fooled into thinking that you've washed your hands of a contract just because you didn't sign it. Automatic participation clauses require you to send a written opt-out notice within 60 days to void the agreement.

ICD-9, CPT Codes for Overweight, Obesity and Associated Complications Members Only Document

A list of codes most frequently used when treating overweight, obese, or at risk patients.

About PA-NEDSS: The Online Disease Reporting System
Physicians and practices must use this system to report communicable and non-communicable diseases.

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