Part B Mythbuster: These 7 Deadly Myths Could Damage Your Practice

Why This Topic Matters

Understanding these misconceptions can help practices reduce compliance risk, improve billing consistency, and better navigate payer rules across Medicare, Medicaid, and secondary coverage.

Article Sections

1. Introduction

   An overview of common coding and compliance misconceptions in medical practice billing.

2. Myth 1: You have to bill everyone the same amount

   Discussion of billing consistency, fee schedules, and the role of practice policies and payer relationships.

3. Myth 2: Before you write something off, you have to send three bills

   General guidance on collection efforts, write-offs, financial hardship, and payer contract considerations.

4. Myth 3: You can only bill one diagnosis code per claim

   Overview of diagnosis reporting, medical necessity, and how diagnosis coding reporting has evolved.

5. Myth 4: E/M codes are assigned solely by the level of medical decision-making (MDM)

   A broad look at evaluation and management coding components and how they relate to patient encounters.

6. Myth 5: If you're a Medicaid provider, you have to accept all Medicaid patients

   State-level variation in Medicaid participation and the importance of checking local program rules.

7. Myth 6: Medicare HMOs have to follow the same rules as Medicare

   How Medicare Advantage-style plan requirements may differ from traditional Medicare in coverage and administrative rules.

8. Myth 7: Secondary insurance always pays what Medicare doesn't

   General coordination-of-benefits concepts involving secondary and supplemental coverage.