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August 20th, 2019
Are You Aware of Medicare Advantage Plans Timely Filing Rules?
Published August 20th, 2019|
The Medicare Fee for Service (FFS) program (Traditional or Original Medicare) has a timely filing requirement; a clean claim for services rendered must be received within one year of the date of service or risk payment denial. As any company who has billed Medicare services can attest, the one-year timely filing ...
April 23rd, 2019
What is Medical Necessity and How Does Documentation Support It?
Published April 23rd, 2019|
We recently fielded the question, “What is medical necessity and how do I know if it's been met?" The AMA defines medical necessity as: It is important to understand that while the AMA provides general guidance on what they consider medically necessary services, these particular coding guidelines are generic and may be ...
March 1st, 2019
Understanding NCCI Edits
Published March 1st, 2019|
Medicare creates and maintains the National Correct Coding Initiative (NCCI) edits and NCCI Policy Manual, which identify code pair edits. When performed on the same patient, on the same day, and by the same provider, the secondary code is considered an integral part of the primary code, and payment for ...
January 10th, 2019
Are You Protecting Your Dental Practice From Fraud?
Published January 10th, 2019|
With the expansion of dental coverage through Medicaid and Medicare Advantage plans, an ever-increasing number of dental claims have come under scrutiny for fraud. One such payer, Aetna, is actively pursuing dental fraud by employing their special investigative units (SIUs) to identify and investigate providers who demonstrate unusual coding and ...
February 1st, 2018
Don’t Be Hesitant About Collecting Co-Pays
Published February 1st, 2018|
If you are hesitant about collecting co-pays, consider that you may be paying interest on credit cards, property mortgages, and business loans. Each dollar that you do not collect in co-pays could have been used to pay down the practice debt. Without question, if you are having difficulty finding ways ...
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October 5th, 2018
New Patient Processing & How to Maximize Reimbursement -November 13th, 2018
In this webinar, Dr. Marty Kotlar (certified coding and compliance expert) will discuss new patient essentials as it relates to the initial paperwork, cash plans, deductibles and wellness care. You’ll also learn how to eliminate insurance and the in-network vs. out-of-network pros and cons.
September 24th, 2018
Skyrocket Cash Collections, Even When Patients Have High Deductibles and Copays
Are you seeing $5,000, $7,500, and even $10,000 deductibles? We're hearing doctors from every state tell us they can't believe how high patients' insurance deductibles are getting. Some are even reporting patient copays of $50 - $60. (That's more than most docs charge for their adjustment!) When accepting insurance, do you know that you CAN'T discount services that apply to these large deductibles? And you can't treat them as "cash" patients. There is a way to overcome this problem of rising deductibles & copays and collect more cash - all while still accepting insurance. This one strategy alone will help you increase your case acceptance, even when patients have $10,000 deductibles. Join Dr. Miles Bodzin for this information-packed presentation. If you're going to be able to serve your communities and sleep well at night, you need this information.
March 28th, 2018
How to Handle High Deductibles, Cash Plans and Pre-Pays
In this webinar, Dr. Marty Kotlar (certified coding and compliance expert) will discuss how to handle high deductibles, pre-pays, discounts, hardships and in-network vs. out-of- network care plans. Learn what the OIG is looking for when it comes to discounts and offering free services.
March 28th, 2018
Outsourcing Your Insurance Verifications to Increase Profits, Save Time & Decrease Overhead
Join Dr. Tom Necela of The Strategic Chiropractor to learn why outsourcing insurance verifications can be an ideal solution to fix one of the biggest insurance headaches that plagues chiropractors and their staff. Virtually every chiropractor agrees that insurance verifications are both a necessary evil and a huge waste of staff time. In this webinar, Dr. Necela will discuss how to increase your profits, save time and decrease overhead by utilizing a simple outsourcing strategy that any chiropractic office can employ!
ACA Clarifies Aetna PolicyAnnual and Lifetime Limits; PPACA UpdatesComplaince Program Guidance for Third-Party Medical Billing CompaniesCompliance Program Guidance for Medicare+Choice OrganizationsData on Application and Coverage Denials - by Government Accountability OfficeDiscount Plan or Health Insurance? by FTCFact Sheet for Chiropractic Services - by the VAFECA - Additional Info & Enrollment CenterFederal Employees Health Benefits (FEHB) ProgramGrandfathered PlansHealth Savings Accounts (HSAs) in the newsMap of States & Jurisdictions - by the National Association of Insurance CommissionersMedicaid Benefit for Children and AdolescentsMedicare Advantage Plans: Cost Sharing LimitsMedicare Medical Savings Account (MSA) Plans - by CMSMultiple Employer Welfare Arrangements (MEWA)Personal Injury Topics PagePreventive Services Covered by the Affordable Care ActSelf-Funded Plans and the PPACA: Is this the new normal?TriWest to Administer VA Patient-Centered community Care ProgramVA Patient-Centered Community Care (PC3) FAQ SheetWhat is Integrated Care - by the Substance Abuse and Mental Health Services Administration (SAMSA)
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