The Medicare Advance Beneficiary Notice (ABN) may carry the tagline Annoying, But Necessary but this does not mean that providers can ignore it or worse, wing it when it comes to implementing it correctly. We consider that KMC University members are under our care and protection, which includes keeping them up to date on important changes, updates, and news that can affect their reimbursement and compliance. This content is meant for members. We’d love to…
Each time a provider submits a claim, the data is analyzed, and the findings are used to create policies, establish procedures, increase efficiency, and reduce fraud, waste and abuse. We consider that KMC University members are under our care and protection, which includes keeping them up to date on important changes, updates, and news that can affect their reimbursement and compliance. This content is meant for members. We’d love to help you come under our…
In mid-year 2022 Cigna spoke about a pre-bill review on all E/M services that are billed with modifier-25. This was placed on hold until the first quarter of 2023. It appears that in some regions only the re-evaluation codes may be impacted. Yet some payer updates state ‘all E/M codes submitted with modifier-25 appended.” We consider that KMC University members are under our care and protection, which includes keeping them up to date on important…
Starting February 1st all appeals must be submitted electronically for United Healthcare UHC claims. From reconsiderations to appeals, the electronic only submission requirement will impact providers nationwide. We consider that KMC University members are under our care and protection, which includes keeping them up to date on important changes, updates, and news that can affect their reimbursement and compliance. This content is meant for members. We’d love to help you come under our umbrella of…
The No Surprises Act is more than just a balance billing protection law for patients. It can be a challenge to determine what portion of this complex law applies to DCs and what is or is not being enforced. This quick summary will hopefully assist your clinic in creating a To Do list for 2023 as it relates to NSA obligations. We consider that KMC University members are under our care and protection, which includes…
Unfortunately, it appears there has been a Medical Policy revision that might be causing this procedure code to be denied. Most of our payer updates are very brief, but this one deserves close attention as there may be a domino effect with other payers. We consider that KMC University members are under our care and protection, which includes keeping them up to date on important changes, updates, and news that can affect their reimbursement and…