Medical Billing Blog

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Surgery Billing – A Guide to Medicare’s Global Surgery Package

August 20, 2019

surgery billing and the global package
 

When it comes to medical billing for surgery, there are various claim submission requirements within Medicare. The largest and most broadly applied is called The Global Surgery Package, or more simply, Global Surgery.

Global surgery refers to all the necessary services performed by a surgeon before, during, and after a surgical procedure. It also includes any necessary services performed by members of that surgeon’s team (provided they practice within the same specialty).

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Telemedicine Guide: Medicare Coverage and The Medical Billing Process

June 27, 2019

Telehealth doctor providing services
 

Every year, telemedicine grows in popularity. More than half of U.S. hospitals already have some sort of telemedicine program, and countless more hospitals are currently developing programs. By 2022, analysts believe that the telemedicine industry will be worth as much as $70 billion.

To accommodate this growing healthcare trend, commercial health insurers are increasingly adopting new telemedicine coverage plans, as well as expanding existing plans. For physicians looking to grow their practices, now is the time to jump into Telehealth, as coverage has expanded to the point where it makes fiscal sense. In fact, most mid-range insurance plans now cover telemedicine to some extent.

However, before jumping into this new form of care, it’s important to understand how the reimbursement process works. As with most new forms of medical treatment, The Centers for Medicare and Medicaid Services (CMS) has set the initial coverage standards through Medicare. The commercial carriers have followed suit, with similar coverage rules.

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MIPS 2019 – Summary of the Biggest Changes to the 2019 Final Rule (vs. 2018)

March 1, 2019

medical billing prices
 

MIPS 2019 is here. It may seem too soon, as some clinicians are still finishing their reporting for the MIPS 2018 performance year. However, the time has come. The Quality performance category requires clinicians to report a full year’s worth of data. So, the sooner providers start, the better.

To help you get going quickly, we’ve summarized the biggest changes to the MIPS 2019 Final Rule, as compared to 2018.

As this is the third year of MIPS, the requirements have increased, along with the potential penalties. The CMS is raising the stakes, so to speak. However, clinicians can still avoid negative payment adjustments without too heavy a burden. While the demands have technically doubled for 2019, providers still only need to score 30 out of 100 possible points to escape penalty. That’s certainly doable.

 
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MIPS Participation Guide for 2018

October 16, 2018

 

The purpose of this post is to walk you everything you need to know in order to successfully participate in MIPS for the 2018 performance year. Whether you’re relatively fluent in MIPS or a complete beginner, we hope you’ll leave with a general understanding of the MIPS system and what’s required of you.

If you’re completely new to MIPS, check out the following links before reading the remainder of this article.

  1. Our MIPS Page: Contains a general explanation of MIPS, along with information about who must participate in 2018, the evaluation criteria (Performance Categories), and Reporting Options for providers
  2. MIPS 2018 Overview and Assistance: A blog post containing information about MIPS 2018 eligibility, exemptions, and logistics

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