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

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Judge Orders Changes to the Independent Dispute Resolution Process

A February ruling by Judge Jeremy D. Kernodle in the U.S. District Court for the Eastern District of Texas found portions of the independent dispute resolution process, established by the Departments of Health and Human Services, Labor, and Treasury during last year’s surprise billing rulemaking, to be inconsistent with the No Surprises Act. READ MORE

Avoiding Provider Enrollment Delays

While bringing on new physicians or other clinicians is an important part of building your medical practice, enrolling them with commercial and government payers can be time consuming…and costly. The tedious process leaves plenty of room for error and delay, both of which can mean missed opportunity for payment. As you work through enrolling providers, here are a few tips to ensure a timely and successful process. READ MORE

Medicare Appeals: When, How, and Where

When claims are denied by Medicare, providers have the right to appeal the decision. In fact, providers can appeal a decision up to five times–all the way to a judicial review in U.S. District Court–if they disagree with the rulings. But not all denials merit an appeal, and when they do, each level of appeal is different and must be sent to a different contractor. Wondering if an appeal is your next step? Here’s how to know when you should appeal and at what level and where to send it. READ MORE

Providing, Documenting, and Coding Medication Assisted Treatment in the ED

Emergency departments serve on the frontline of the fight against drug overdoses and opioid use disorder. While there have been several barriers to providing and billing for medication assisted treatment in the ED, many of those barriers have been reduced or eliminated. When emergency physicians do administer and/or prescribe MAT, here’s what they should document and code for their services. READ MORE

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