Telehealth Changes in 2025: What Physicians Need to Know
Telehealth Changes in 2025: What Physicians Need to Know The Centers for Medicare & Medicaid Services (CMS) have announced their updates for 2025, and unfortunately, many of these changes are likely to make managing telehealth services more complex for medical practices. While telehealth has proven to be a lifeline for patients and providers alike, especially […]
Understanding Modifier 25 in Preventive Visits: Billing with Care to Avoid Added Costs
While I have done podcasts and posts on this topic before, its incredibly important to go over some specific example that we came across regarding misuse and really want to make sure our readers and audience understand the nuances. When it comes to preventive visits in healthcare, many patients expect a straightforward experience focused on […]
HHS Finalizes Medicare Payment Rule for 2025: The Reality Behind Cuts and Telehealth Rollbacks
The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have rolled out the new Medicare Physician Fee Schedule (PFS) for 2025, with some changes that sound positive but come with real drawbacks. From payment cuts to telehealth restrictions, here’s what this means for physicians and their patients—and […]
STOP Leaving Money on the Table with Eligibility Denials
You can’t control insurance companies. BUT YOU CAN CONTROL THIS!!! When it comes to running a healthcare practice, verifying insurance is one of those crucial yet often overlooked processes that can make or break your revenue cycle. If not done correctly before the patient is seen, you might find yourself providing services for free, or […]
Why You Need to Update Your CPTs and ICD-10 Codes Annually
In today’s fast-paced healthcare environment, staying current with the latest medical coding updates is more important than ever. As a healthcare provider, ensuring that your practice’s systems are up to date with the newest CPT (Current Procedural Terminology) and ICD-10 (International Classification of Diseases, 10th Edition) codes is essential to maintaining a smooth workflow and […]
How to Fix: Bank Deposits Matching EHR Postings
Managing the financial aspects of a medical practice can be complex, especially when it comes to ensuring that the payments recorded in your Electronic Health Records (EHR) or Practice Management (PM) software align with the actual deposits in your bank account. Discrepancies can lead to confusion, financial mismanagement, and potential cash flow issues. In this […]
Understanding Denied vs. Rejected Claims in Medical Billing
Medical billing is a critical process in healthcare, ensuring that providers get paid for their services. However, navigating the complexities of insurance claims can be challenging, particularly when dealing with denied and rejected claims. Understanding the difference between these two types of claims and knowing how to avoid common pitfalls can significantly improve the efficiency […]
The Importance of a Business Case in Healthcare Decision-Making
In the rapidly evolving landscape of healthcare, making informed and strategic decisions is more critical than ever. Whether you’re contemplating the purchase of new medical equipment, considering an expansion of services, or implementing cutting-edge technology, the foundation of these decisions should be a well-crafted business case. This document not only guides decision-making but also ensures […]
Billing Tip for Pediatric Immunizations
Fellow healthcare providers, when we encounter pediatric patients who are behind on their immunizations, it’s crucial to understand the appropriate billing practices for immunization counseling and administration. 📝 Key Points for Accurate Billing: 📊 Efficient Practice Management: 📢 Action Items: 🔍 For More Information: 🤝 Let’s ensure our billing practices are as effective as our care, keeping our focus […]
CMS Update on Shared or Split Services
The landscape of medical billing and compliance continues to evolve, with the Centers for Medicare & Medicaid Services (CMS) and the Current Procedural Terminology (CPT) introducing significant updates to the shared or split services policy in 2024. These changes, which expand the definition of split/shared services and modify the requirements for service billing and documentation, […]
