No Surprises Act
On January 1st, 2022, the No Surprises Act went into effect and it provides federal protections for patients from surprise medical bills.
1-Minute Pro Tip: How to Handle Claim Denials from Private Insurance Companies
Before challenging a claim, examine the reason for your denial. The reason for the payer’s denial can be found on the Explanation of Benefits or EOB. In some cases, the…
Sample Letter: Enlisting Patients Assistance for Claims Payment
Enlisting patient assistance in health insurance claims payment issues.
Updates to UnitedHealthcare Cost-Share Waivers
To ensure members are able to access the care they need as the COVID-19 pandemic continues, UnitedHealthcare is expanding cost share waivers for our Medicare Advantage and Individual and Group…
Digital Therapeutics and Healthcare Reimbursement
Many digital therapeutics (DTx) providers are working to obtain reimbursement from U.S. payers. The following post discusses stategy for reaching patients and partnerships. A reputable DTx company will have a…
Physical Therapy Referrals: Not Needed
Physical therapist services are generally covered as a basic benefit by all major health insurance companies. Ask your physical therapist to contact your insurance company to determine your specific benefits.
E&M Coding Advice: Simplified
E&M Coding Advice Physicians and Medicare alike have struggled for many years with correct coding, documentation, and payment of evaluation and management (E&M) services. That's because, by their nature, E&M…
E&M Coding Advice: Simplified
E&M Coding Advice Physicians and Medicare alike have struggled for many years with correct coding, documentation, and payment of evaluation and management (E&M) services. That's because, by their nature, E&M…
Don’t Lose Revenue With an Outdated Fee Schedule
If you have not updated your practice's fee schedule for several years, you may be in for some surprises. Carenodes Advisory recommends that you analyze and update your fees annually…
Sample Letter (SB 418): Paper Claim in Process Over 45 Days (TEXAS MARKET)
Sample Letter (SB 418): Paper Claim in Process over 45 days Dear Payer: Please be advised that this letter is to request final resolution of the claim/services in question. ...…
Health and Behavior Assessment and Intervention Codes vs. Psychotherapy
The Health and Behavior Assessment and Intervention Codes vs. Psychotherapy: How Codes and Reimbursements Differ
Health Behavior Assessment and Intervention Reimbursement Guidance: both Money and Preventive Care Opportunities on the Table
Health Behavior Assessment and/or Intervention (HBAI) “Health and Behavior Assessment procedures are used to identify the psychological, behavioral, emotional, cognitive, and social factors important to the prevention, treatment or management of…
Documentation and Billing of Mental Health Services: Incident – to Billing
BY CARENODES ACADEMY Lines of Business: Medicare, (some private payers) Certain services provided by your employee (or a fellow employee) may also be eligible for Medicare payment, but check your…
Rates: Health Behavior Assessment Services Assessment or Reassessment Reimbursement Table
Health Behavior Assessment Services Assessment or Reassessment Reimbursement Table
Physical Therapy Incident-to Billing Guidance
Evaluation and Management Coding for Physical Medicine and Rehabilitation Incident-to services are services performed that are integral to and an incidental component of the physician’s professional services in an outpatient…