Due to the federal "transparency in coverage" rule, BCBSVT is now requiring all providers to obtain and start utilizing an Employer Identification Number (EIN) for billing.

E/M Changes for BCBSMA 2020 Blue Cross Blue Shield of Massachusetts has advised that, effective April 1, 2020, they will implement a reduced reimbursement policy when you bill an E/M service on the same day as a procedure.  Starting on April 1, 2020, BCBS will begin to reimburse the lesser allowable service at 50% of […]

Medicare has released the results of the CMS Final Rule 2019. They have announced that the changes to the E/M coding will be effective for Calendar Year 2021. Currently these codes will remain the same.

All physicians who hold an active medical license in Massachusetts must enroll in Mass Health either as billing or non-billing providers – in order to maintain their licensure.

CMS will begin mailing new insurance cards in April 2018, replacing all Medicare cards by the April 2019 congressional deadline.

Medicare beneficiaries will often purchase "Medigap" insurance polies to cover their co-payment and deductible costs after Medicare. However, starting in 2020 Medigap plans will no longer...

The new system is designed to offer features that will increase the ease of use and functionality for providers.

Effective January 1, 2015 - Medicare has 4 new HCPCS modifiers to define subsets of the modifier 59 "Distinct Procedural Service". Learn More...

Routine Forgiveness of Co-Payments – Published by the American Medical Billing Association Routine forgiveness or waiver of copayments may constitute fraud under state and federal law. Where the insurance contract requires a doctor to make reasonable attempts to collect the patient’s portion, an open question surrounds the definition of “reasonable attempts to collect the debt.” Historically, […]

2014 Rules for PQRS Original posting and content found here: http://www.mdinteractive.com/2014-PQRS   CMS issued Final 2014 Physician Fee Schedule Rule on November 27, 2013. Summary of Changes: 2014 PQRS measures group reporting  can only be done with a registry. It could be easier for a provider to report 2014 PQRS with a registry instead of using claims because a […]

September 23, 2013 is the date that medical practices and other covered entities must update their Notice of Privacy Practices (NPP) to patients in order to be compliant with the HIPAA Omnibus rule enacted in March 2013.

Why outsource your billing processing? By keeping your billing in-house you incur the: Expense of your billing system (the initial investment as well as continuous updates and support costs) Employee salaries, benefits, health insurance, and staff training as well as payroll taxes, workmen’s compensation and liability insurances Computer maintenance Expense of supplies and postage Cost […]