Medical Billing

It's critical to have a systemized and strategic reporting technique in place to follow the status of each and every claim from the time the patient registers to the time the claim is closed with full payment. To avoid refusal claims taking a back seat and ending up in older AR buckets, contact a billing professional for help with an efficient Medical Claims tracking Reporting system. You must first determine the Scope and Out of Scope of your inventory before you can begin working on it. Example: You may not work on Liability Insurance which is out of Scope for you Once you identified the scope of the inventory you need to Prioritize the inventory. Below give the sample for prioritization Prioritize Claims: First Priority: Higher aging and High dollar value Second Priority: Denied Claims Third Priority: Second Higher aging and Dollar value  Fourth Priority: TFL Experienced AR Follow up and Denial Management Team A skilled AR Followup, Rejection, and Denial Management staff are req...

 The American Medical Association (AMA) announced a Current Procedural Terminology (CPT) code set update to include a code for administering a third dose of Pfizer’s COVID-19 vaccine in children 5 through 11 years of age. CPT code 0073A was added to the official CPT code set, effective immediately. The addition comes on the heels of the Food and Drug Administration’s (FDA’s) decision to expand Pfizer’s COVID-19 vaccine emergency use authorization to include a third primary series dose of the vaccine in children who are immunocompromised. The FDA’s decision to allow immunizers to boost certain children susceptible to poor outcomes if they become infected with COVID-19 is a welcome action, AMA stated.

  The No Surprise Act 2022 (NSA) establishes new federal protections against surprise medical bills that take effect in 2022.  What is No Surprise Act: NSAs occur when insured people are treated by out-of-network hospitals, doctors, or other providers they did not choose. This occurs in around one out of every five visits to the emergency room. In addition, surprise expenditures from out-of-network doctors (such as anesthesiologists) whom the patient did not choose an account for 9 to 16 percent of in-network hospitalizations for non-emergency care. Consumers suffer unexpected medical expenditures when health plans decline out-of-network claims or impose greater out-of-network cost-sharing; consumers also face "balance billing" from out-of-network providers who have not agreed to accept the health plan's discounted payment rates. The NSA is expected to apply to around 10 million out-of-network unexpected medical expenses per year, according to the federal government. Th...