What to Do if a Medicare Patient’s MBI Changes
Providers who receive an eligibility error code on their Medicare claims should check to see if the patient’s Medicare Beneficiary Identifier (MBI) has changed.
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United Healthcare Increases Scrutiny of Professional Emergency Claims, Too
United Healthcare will begin evaluating all level 5 professional Emergency Department claims and potentially downcoding them or denying them for “inappropriate” coding. The new policy, which takes effect April 1, 2020, is part of the payer’s “continued efforts to reinforce accurate coding practices.” READ MORE
Straddling Three Years of MIPS: What You Need to Know Now about 2018, 2019, and 2020
With a new year comes a few months of straddling three different performance periods for the CMS’s Merit-based Incentive Payment System. Here’s a look at what you need to know now about the 2018, 2019, and 2020 MIPS performance periods. READ MORE
8 Things to Know about CPT Changes for 2020
Back in September 2019, the American Medical Association released the 2020 Current Procedural Terminology code set. Those changes will become effective on January 1, 2020. In this post, we highlight eight noteworthy ones. READ MORE
5 Things to Know about Indiana Medicaid for 2020
As we wrap up 2019, the Indiana Health Coverage Programs (IHCP) has released a variety of information Indiana healthcare providers need to know about billing Medicaid in 2020. We’ve created a short list of the top five things you should know. READ MORE
8 Things to Know about Medicare for 2020
As we wrap up 2019, the Centers for Medicare and Medicaid Services has released a variety of information healthcare providers need to know about billing Medicare for 2020. We’ve created a short list of the top eight things providers should know. READ MORE
CMS’ Advanced Use Criteria Program No Longer Voluntary Starting January 1, 2020
Starting January 1, 2020, providers who order Medicare Part B advanced diagnostic imaging services are required to consult appropriate use criteria through a qualified Clinical Decision Support Mechanism. READ MORE
2020 Medicare Physician Fee Schedule: What Anesthesiologists Need to Know
CMS recently published the final draft of the Medicare Physician Fee Schedule for 2020, including the new anesthesia conversion factor of $22.2016, a slight decrease from 2019, and revisions to several Medicare payment policies. We’ve highlighted a few changes that will be most interesting to anesthesiologists. READ MORE
2020 Medicare Physician Fee Schedule: What You Need to Know
CMS recently published the final draft of the Medicare Physician Fee Schedule for 2020. We’ve highlighted a few of the biggest changes. READ MORE
2020 Medicare Physician Fee Schedule: What Emergency Physicians Need to Know
CMS recently published the final draft of the Medicare Physician Fee Schedule for 2020. In addition to changing the payment rates for 2020, the Final Rule also mandates changes to several payment policies. We’ve highlighted a few of the biggest changes that would be most interesting to emergency physicians. READ MORE
