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Unbundling

What’s the Difference Between Comprehensive, Component, and Modifier Codes?

February 9, 2024 / admin / Articles, Billing, Bundled Payments, Bundling, Component Codes, Comprehensive Codes, CPT Manual, Healthcare, Healthcare Billing, Medical, Medical Billing, Modifier Code, Modifiers, Unbundling
Medical CPT Codes

Medical billing and coding is an intricate process that requires the use of different types of codes to accurately document procedures, services, diagnoses, and supplies. Three important types of codes are comprehensive codes, component codes, and modifier codes. Understanding the differences between these code types is crucial for accurate medical billing and reimbursement. Comprehensive Codes […]

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-AS, -AT, -CG, -LT, -RT, Adjunct Services, ancillary services, Billing, Bundling, Care Settings, Component Codes, Comprehensive Codes, CPT Manual, Healthcare, Healthcare Billing, Laterality, Medical, Medical Billing, Modifier Codes, Modifiers, Patient Conditions, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Unbundling, Unusual Circumstances

The Essential Guide to Avoiding Improper Bundling in Medical Billing

February 6, 2024 / admin / Articles, Bundling, Component Codes, Improper Bundling, Medical Billing, Medically Unlikely Edits, Modifier Code, Modifier Codes, Modifiers, MUEs, National Correct Coding Initiative, NCCI, NCCI Edits, Proper Bundling, Unbundling
White Female Medical Billing Outsourced

Improper bundling in medical billing can lead to denied claims, payment delays, audits, fines, and even fraud allegations. As a medical billing professional, it’s crucial to understand how to bundle procedures correctly to ensure proper reimbursement while adhering to CMS guidelines. In this guide, we’ll cover everything you need to know about avoiding improper bundling […]

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Claim Denials, Component Codes, Comprehensive Code, CPT, CPT codes, Denied Claims, Denied Medical Claims, HCPCS, Medically Unlikely Edits, Modifier Codes, MUEs, National Correct Coding Initiative, NCCI, NCCI Edits, Unbundling

Top Coding and Billing Errors to Avoid

September 5, 2023 / admin / Articles, Authorization Failures, Bad Sequencing, Benefits Errors, Billing, Billing Duplicates, Duplicate Coding, EOB Errors, Expired Policy Numbers, Grouping Errors, Insufficient Modifiers, Invalid Linkages, Invalid Place of Service, Missing Codes, Missing Modifiers, Poor Handwriting, Timed Coding Errors, Unbundling
Medical Billing White Guy

Accuracy in both medical coding and billing processes is imperative for maximizing appropriate reimbursement, maintaining regulatory compliance, and optimizing revenue cycle performance. Even minor errors can have major consequences in delayed or reduced payments, denied claims, and compliance risks. We cover the most common coding and billing mistakes along with best practices to identify where […]

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Authorization Failures, Bad Sequencing, Benefits Errors, Billing, Billing Duplicates, Duplicate Coding, Duplication, EOB Errors, Expired Policy Numbers, Grouping Errors, Inaccurate Patient Info, Inaccurate Patient Information, Inadequate Specificity, Incorrect Code Assignments, Incorrect Units, Insufficient Modifiers, Invalid Linkages, Invalid Place of Service, Medical Billing, Missing Codes, Missing Modifiers, Poor Handwriting, Timed Coding Errors, Timeliness Issues, Unbundling, Upcoding

Detecting and Preventing Healthcare Fraud and Abuse: A Comprehensive Guide

July 5, 2023 / admin / Articles, Detecting Healthcare Fraud, Healthcare, Healthcare Abuse, Healthcare Fraud, Healthcare Fraud Abuse, Medicaid, Medicaid Fraud, Medical, Medicare, Medicare Fraud, Preventing Healthcare Fraud, Unbundling, Unusual Billing Patterns
Group of Medical Doctors Sitting at Table

At Medwave, we are dedicated to providing valuable insights and guidance on detecting and preventing healthcare fraud and abuse. We will equip you with the knowledge and tools necessary to safeguard your organization and patients from these malicious activities. Implementing the strategies outlined below allows you to enhance the integrity of your healthcare services and […]

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Detecting Healthcare Fraud, Fraud, Healthcare, Healthcare Abuse, Healthcare Fraud, Healthcare Fraud Abuse, Medicaid, Medicaid Fraud, Medical, Medical Fraud, Medicare, Medicare Fraud, Phantom billing, Preventing Healthcare Fraud, Unbundling, Unusual Billing Patterns

Common Cases of Medicare, Medicaid Fraud

December 8, 2021 / admin / Articles, False Claims Act, Fraud, Medicaid, Medicaid Fraud, Medicaid Fraud Examples, Medicare, Medicare Fraud, Medicare Fraud Examples, Phantom Billing, Unbundling, Upcoding
Medicare Fraud

Medicare, Medicaid Fraud Examples and Steps to Ensure You Don’t Commit It *These are examples of fraud as it relates to Medicare and Medicaid. Medical fraud is the intentional deception or misrepresentation of healthcare transactions by the provider for the sake of receiving unauthorized benefits or financial gain. Healthcare fraud is committed when a dishonest […]

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Billing Fraud, False Claims Act, Fraud, Medicaid, Medicaid Billing, Medicaid Fraud, Medicaid Fraud Examples, Medical Billing Fraud, Medicare, Medicare Billing, Medicare Fraud, Medicare Fraud Examples, Upcoding

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Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Urgent Care
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Recent Posts

  • How to Fight Back Against Low Out-of-Network Payments

    How to Fight Back Against Low Out-of-Network Payments

  • Male Filipino Medical Doctor Smiling

    The Essential Physician Credentialing Checklist

  • White male medical doctor signing credentialing document

    Can Providers Practice w/ Pending Credentialing Applications?

  • Medical Credentialing Expert Female Mulatto

    Turn Your Payer Contracts Into Higher Reimbursements

  • White Female Medical Credentialing Expertise

    Credentialing Specialists: The Gatekeepers of Healthcare Safety

  • CAQH Profile Current -- Two Doctors

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