Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

Health Insurance

Planning Ahead for No Surprises Act Implementation

The No Surprises Act, which was signed into law in December 2020, won’t go into effect until at least January 1, 2022. But that isn’t slowing down provider groups from working to ensure the details of the bill, which will be administered through by agencies like the Departments of Health and Human Services, Labor, and Treasury, are ironed out with their interests in mind. READ MORE

Indiana Medicaid’s Third-Party Liability Disallowance Project: What You Need to Know

Indiana’s Third-Party Liability Disallowance Project supplies Indiana Medicaid providers with Medicare and third-party commercial insurance information to properly bill claims to the primary carrier. Managed by the Indiana FSSA Office of Medicaid Policy and Planning, the TPL Disallowance Project identifies paid Indiana Medicaid claims for which there is third-party coverage and notifies providers of the third-party coverage information. READ MORE

MIPS Extreme and Uncontrollable Circumstances Flexibilities Extended for 2020

The Centers for Medicare and Medicaid Services is automatically applying its extreme and uncontrollable circumstances policy to all MIPS eligible clinicians for the 2020 performance period. The agency also is reopening the MIPS EUC application for individual MIPS eligible clinicians, groups, virtual groups, and Alternative Payment Model Entities through March 31, 2021. READ MORE

Pre-Anesthesia Evaluation, Pre-Surgery History & Physical, and Separately Reported E/M Services: Know the Difference

While recent changes to office or other outpatient evaluation and management coding and billing guidelines may not affect anesthesiologists most of the time, there are instances when knowing the new rules will come in handy, especially with patients who have complex medical co-morbidities. READ MORE

Providing and Billing for Medication Assisted Treatment for Opioid Use Disorder in the ED

In the 2021 Medicare Physician Fee Schedule, CMS finalized the creation of add-on G-code, G2213, to be billed with E/M visit codes used in the ED setting for medication assisted treatment of opioid use disorder. Having a code to use, however, is not the only hurdle for emergency physicians to cross in providing and billing of MAT for the treatment of opioid use disorder. READ MORE

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