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December 3rd, 2019
Answering the Question: Does my Insurance Cover Chiropractic Care?
Published December 3rd, 2019 - Last Review/Update December 4th, 2019|
The question "Does my insurance cover chiropractic care" is the ongoing question chiropractic offices have struggled with for years. Unfortunately, when it comes to insurance, coverage often varies between payers — even varying between plans for a single payer so there isn't one easy answer.
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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ACA Clarifies Aetna PolicyComplaince 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 FTC
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