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Doctors

Third Party Liability Division Commercial Coverage

Yeo & Yeo Medical Billing & Consulting

The Michigan Department of Health and Human Services (MDHHS) Third Party Liability Division (TPL) partners with commercial health insurance companies to receive their coverage information. This information is directly verified with their official eligibility source. Each insurance company assures that policies in CHAMPS are ... Read about the TPL Commercial Coverage

Windows

AMA on Track to Revise E/M Codes -- Set New Documentation Guidelines

Yeo & Yeo Medical Billing & Consulting

The AMA’s CPT Editorial Panel approved sweeping changes to documentation and code selection guidelines for evaluation and management codes. If finalized, the changes would shift the way practices select codes for both office and facility visits as soon as January 2021. Approved ...

Billing

Correct Service Descriptions When Billing Not Otherwise Classified Codes

Yeo & Yeo Medical Billing & Consulting

Not Otherwise Classified (NOC) codes are used for services that do not have an existing CPT code that accurately identifies the service or procedure performed. Services billed under NOC codes will be denied as billing errors if codes describing the services are available. Wisconsin Physicians Service (WPS) ... View the examples

Doctor

Qualified Medicare Beneficiary Billing Requirements

Yeo & Yeo Medical Billing & Consulting

The Qualified Medicare Beneficiary (QMB) program provides help with Medicare premiums and cost-sharing for enrolled individuals. More than one out of eight people with Medicare are in the QMB. Medical providers are prohibited by federal law from billing people in the QMB program for Medicare deductibles, ... View the requirements

Paperwork

Resources for MIPS Reporting

Yeo & Yeo Medical Billing & Consulting

The Merit-based Incentive Payment System (MIPS) is a program through which participating providers are evaluated and rewarded for improvement based on their performance in four categories. Performance is measured through data reported in four areas: Quality - 45% Promoting Interoperability - 25% ... Read the resources

MGMA Asks CMS to Extend ACO Application Deadline

Yeo & Yeo Medical Billing & Consulting

MGMA groups came together to write to the Centers for Medicare & Medicaid Services (CMS), asking them to extend the application deadline for accountable care organizations (ACOs) that wish to participate in the Medicare Shared Savings Program (MSSP) beginning July 1, 2019. The CMS ... Read about the MGMA request

Money

New Medicare Payment Models

Yeo & Yeo Medical Billing & Consulting

The Centers for Medicare and Medicaid (CMS) released two new voluntary payment models for Medicare Advantage and/or Medicare Part D plans to further the value-based payment agenda. Both will run from 2020 through 2024. Updated VBID The first model is an updated version of the Value-Based Insurance ... Lean more about the new models

10 Medical Practice Issues to Watch in 2019

Yeo & Yeo Medical Billing & Consulting

2019 will be another busy year in healthcare. Highlighted below are ten laws and regulations that will be critical for medical practices in the new year. Participation in voluntary Medicare alternative payment models (APMs) has been relatively static in recent years. Secretary Azar and the Department ... Learn about the 10 medical practice issues

Business

Claims Adjustments are Here for Non-physician Providers

Yeo & Yeo Medical Billing & Consulting

This article is provided by the Michigan Department of Health & Human Services. Visit their website at www.michigan.gov/mdhhs. Claims with dates of services on or after 1/01/16 for professional non-physician providers (Psychologists, Social workers, Marriage/Family Therapists, and Professional Counselors) were ... Learn about the claims adjustments