Navigating the medical billing and coding landscape demands meticulous attention to detail, as precision and accuracy play pivotal roles in securing appropriate reimbursement and upholding regulatory compliance. Among the various tools at a coder’s disposal, modifiers play a crucial role in accurately describing the circumstances under which services are provided. Medicare Modifier XU, in particular, […]
Biling Codes, CMS, Coding, coding and billing, Coding Intricacies, medicare, Medicare Modifier XU, Medicare Modifiers, Modifier Xu, X{EPSU}, X{EPSU} Modifiers, XE, XP, XS, XU
Precision and accuracy are paramount in the world of medical billing and coding. Modifiers play a crucial role in this landscape, allowing healthcare providers to add nuance and specificity to their claims. Among these, Medicare Modifier XP holds a unique position, particularly when it comes to reporting services performed by different practitioners. We’ve furnished a […]
Billing Codes, CMS, Coding, coding and billing, Coding Intricacies, medicare, Medicare Modifier XP, Medicare Modifiers, Modifier XP, X{EPSU}, X{EPSU} Modifiers, XE, XP, XS, XU
Precision is key to ensuring proper reimbursement and maintaining compliance. Among the various tools at a coder’s disposal, modifiers play a crucial role in accurately describing the circumstances under which services are provided. Medicare Modifier XS, in particular, holds significant importance when it comes to reporting procedures or services performed on different anatomic sites or […]
Billing Codes, CMS, Coding, coding and billing, Coding Intricacies, medicare, Medicare Modifier XS, Medicare Modifiers, Modifier XE, Modifier XP, Modifier XS, Modifier Xu, Modifiers, X{EPSU}, X{EPSU} Modifiers, XE, XP, XS, XU
Accurate use of modifiers is crucial for proper reimbursement and compliance in the medical coding and billing industry. Among these, Medicare Modifier XE holds a significant place, particularly when it comes to reporting distinct and separate encounters on the same day. We provide a comprehensive understanding of Modifier XE, its appropriate use, and its impact […]
Billing Codes, CMS, Coding, coding and billing, Coding Intricacies, medicare, Medicare Modifier XE, Medicare Modifiers, X{EPSU}, X{EPSU} Modifiers, XE, XP, XS, XU
If you’re a healthcare provider or facility dealing with Medicare, one thing is certain – getting properly reimbursed is a maze filled with complex rules, convoluted paperwork, and often, sheer frustration. Medicare reimbursement is the lifeblood that keeps many healthcare operations afloat, but navigating its serpentine pathways can feel like a daily battle. Buckle up […]
APC, APCs, CMS, Geographical Practice Cost Index, healthcare, Healthcare Billing, Inpatient Prospective Payment System, IPPS, Medical, Medical Billing, medicare, medicare billing, Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, Medicare Physician Fee Schedule, Medicare Reimbursement, Medicare Severity Diagnosis Related Groups, MIPS, MS-DRG, OPPS, Prospective Payment Systems, Revenue Cycle, Revenue Cycle Management
As US healthcare costs continue rising steeply – now over $4 trillion representing nearly 20% of GDP – both federal and state policymakers urgently seek ways to contain runaway expenditure growth. This drive manifests through expansion of programs like Medicare Advantage and Medicaid managed care coupled with accelerating passage of game-changing legislation like No Surprises […]
billing, Billing Best Practice, Billing Disruption, billing revenue, Claim Data, Consumer-Centered Billing, Good Faith Estimates, Health Level 7, healthcare, HL7, Interoperability, medicaid, Medical Billing Regulations, medicare, No Surprises Act, Pre-Authorization
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. By implementing the strategies outlined below, you can enhance the integrity of your healthcare services and […]
fraud, healthcare, Healthcare Abuse, Healthcare Fraud, medicaid, medicaid fraud, Medical, Medical Fraud, medicare, medicare fraud, Phantom billing
Medicare and Medicaid Fraud is a Massive Healthcare Industry Problem Medicare and Medicaid Fraud Vulnerability The Medicare and Medicaid programs provide crucial support to millions of Americans, offering access to healthcare services for those who may not otherwise be able to afford it. Unfortunately, these programs are also vulnerable to fraud, with criminals exploiting the […]
Billing for services not rendered, billing fraud, False certification, fraud, Kickbacks, medicaid, medicaid fraud, medical billing fraud, medicare, medicare fraud, Phantom billing, Prescription drug fraud, Supply fraud, Unlawful self-referral, Upcoding, Whistleblower, Whistleblower Protection Act
Let’s begin with this set-up: Let’s say you’re hunting for a new job and receive a call from a would-be employer informing you that the job is yours. Of course, you’re thrilled by the news and inquire about your starting salary. Your new employer replies that you need to wait for your first paycheck to […]
Credentialing, healthcare credentialing, medicaid, medicare, private insurers, Provider Credentialing, provider networks, reimbursement rates
Are Mental Health Services (like Therapy) Covered Under Medicare? Behavioral / Mental Health Services + Medicare Sometimes it can be problematic for older adults to differentiate indicators of mental health difficulties for typical aging-related changes. They may think that experiencing sadness or anxiety is an ordinary symptom of growing older, particularly when they live with […]
Behavioral Health, Behavioral Health Billing, medicaid, medicare, medicare coverage, Medicare Therapy, Mental Health, Mental Health Billing
Home Health Services + Medicare What does Medicare Cover for Home Healthcare? If you’re looking for an answer to the question, “What does Medicare cover for home healthcare?”, you’ve probably typed it into a search engine and immediately closed the tab. The amount of information and the level of detail can quickly become confusing and […]
healthcare, healthcare services, home health care, home health services, home healthcare, medicaid, medicaid billing, medicaid coverage, medicare, medicare billing, medicare coverageMedicare, Medicaid Fraud Examples and Steps to Ensure You Don’t Commit It A medical doctor invoiced his patient’s Medicare insurance for both the services he actually delivered and for services that were not delivered. He fabricated his patient’s medical records to indicate office visits and treatments that never took place. A gerontologist obtained the outcomes […]
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
Medical Billing Techniques that Can Be Installed to Help Your Medical Practice Health care providers should periodically review their financials and revenue cycle, so that they can take corrective measures at the earliest if required. A great deal of medical offices / health care providers find that medical billing is one area which could be […]
AI, Automation, EHR, medicaid, Medical Billing, medicare, MIPS, Outsource Medical billing, Pittsburgh Medical Billing
New Medicare Cards are set to arrive in 2018 Due to the rising issues of identity theft in the country, the Social Security Administration fears that the current Medicare cards labeled with beneficiaries social security numbers are a high risk. A bill signed in 2015, by President Obama gives the Department of Health and Human […]
2018 Medicare, 2018 Medicare Cards, Cranberry Medical Billing, MBI, Medical Billing, medicare, medicare beneficiary indentifier, medicare cards, new MBI, new medicare cards, Pittsburgh Medical Billing, social security administration, social security number removal initiative, SSNRI