ASC Coding, Billing & Collections

Modifiers (usually 2-digits) are added to the main procedure code to signify that the procedure has been altered by a distinct factor. Modifiers are accepted by most payors. Modifiers can increase or decrease reimbursement. They can also cause claims not…

CMS has published online most of the edits utilized in its Medically Unlikely Edit (MUE) program to improve the accuracy of claims payments for Medicare Part B services.

Here is the average 2007 Medicare sub charge (submitted charges divided by allowed services), average allow charge (Medicare-allowed charges divided by allowed services, including co-pays and deductibles paid by patient), and average payment (Medicare payments divided by allowed services, not…

Here is the average 2007 Medicare sub charge (submitted charges divided by allowed services), average allow charge (Medicare-allowed charges divided by allowed services, including co-pays and deductibles paid by patient), and average payment (Medicare payments divided by allowed services, not…

Here is the average 2007 Medicare sub charge (submitted charges divided by allowed services), average allow charge (Medicare-allowed charges divided by allowed services, including co-pays and deductibles paid by patient), and average payment (Medicare payments divided by allowed services, not…

Here is the average 2007 Medicare sub charge (submitted charges divided by allowed services), average allow charge (Medicare-allowed charges divided by allowed services, including co-pays and deductibles paid by patient), and average payment (Medicare payments divided by allowed services, not…

Here are seven best practices from managed care contracting experts to help you get paid fairly by third-party payors.

During and following a recent audio conference on orthopedic coding, Stephanie Ellis, RN, CPC, president of Ellis Medical Consulting, responded to questions about challenging orthopedic coding issues from participants in the program. The following are her responses to 17 of…

Managed care expert I. Naya Kehayes, MPH, managing principal and CEO of Eveia Health Consulting & Management, offers the following practical guidance on ten issues to help you with challenging payors.

Here is expert insight to help you overcome four payor challenges. Look for more CMS/third-party payor issues discussed and guidance to help you with your reimbursement challenges in the Sept./Oct. issue of Becker’s ASC Review.