New 2021 E/M Coding Changes You Should Know
Every year payers and public health institutions like the Centers for Medicare and Medicaid Services and the American Medical Association implement changes to their Evaluation and Management coding. Like clockwork, these changes were implemented on January 1, 2021. Physicians and medical practices of every scale need to educate themselves and their staff on these changes to minimize any delays and reduce the risk for potential questions when filing a claim or requesting prior authorization. This also helps ensure that [...]
What Is A Medical Billing Clearing House?
There are many important facets to the medical billing process. One of the most important steps includes the use of a medical billing clearing house. Though not everyone is fully clear about what a medical billing clearing house is, why it’s important and how to choose the best medical billing clearing house to meet your practice’s needs? What Does A Medical Billing Clearing House Do? A Medical billing clearing house essentially acts as a middle man helping to connect [...]
How To Use Medical Billing CPT Modifiers Correctly
Medical billing professionals often have to use modifiers to affect the description of a diagnostic process, treatment plan, or other service performed for a client. This also includes things like prescriptions or other medical supplies that may have been provided to a patient as part of an effective treatment plan. What Are CPT Code Modifiers? A CPT code modifier is a two-digit code that is specifically linked to a CPT code that needs a further description of the [...]
What Is Medical Billing Prior Authorization & When Do You Need It?
Prior authorization plays a critical role in the process of diagnosing, treating, and accurately billing claims that meet a patient’s important medical needs. Medical insurance providers often require it for specific services and specialty treatments. With prior authorization, the patient, and the physician administering treatment are more likely to see a fast, and efficient payment of a claim. With little to no headaches. Without prior authorization, a claim for specialty diagnostics or treatment is more likely to be delayed [...]
How To Maximize Mental Health Insurance Reimbursement Rates?
Most small sustainable mental health practices require the therapist to wear many hats. Often all at the same time. This includes things like being your own administrative assistant, a medical billing specialist, marketing maven, and perhaps even the office janitor. This can be a real challenge, as these other tasks can end up taking your focus off your chosen specialty which is providing your patients with the highest levels of care. Ultimately, the better you understand the business aspect [...]
What is Prompt Hierarchy In ABA Therapy?
Applied Behavior Analysis therapy offers a wide range of techniques to help teach children with autism. Prompt hierarchy may especially helpful for teaching autistic children a new task. This represents an important step in helping a child develop a greater quality of life as an adult. With this ABA treatment strategy “Prompting” refers to the level of instruction a child is given when you ask them to complete a task. It can be a physical, visual, or verbal cue [...]
What is CPT Code 90791; When & How To Use It
CPT Code 90791 is one of the CPT codes most commonly used by licensed behavioral health providers. It is used as part of an integrated biopsychosocial assessment, this includes key details like the patient’s mental state, their history, and recommendations. CPT Code 90791 is typically used for diagnostic evaluations that are related to new behavioral health concerns or illnesses. It’s usually billed for the initial intake appointment and evaluation that each new patient needs to go through at the [...]
How To Maximize Initial Assessment Authorization For The Most Billable Hours
There are a lot of dynamic aspects to the initial assessment and prior authorization process that can impact both providers, and payers, as well as patients. Prior authorization is essentially a type of management practice used by health insurance providers. It requires specific tests procedures, and medication prescriptions to be first evaluated as they related to the cost of care. This important process is designed to find the least expensive, effective treatment option to keep the cost of care [...]
Common ABA Therapy Billing Mistakes & Tips To Prevent Errors
Billing code errors can cause a major interruption in your practice’s revenue stream, leading to delays and potential claim denials. Making yourself aware of the common causes of billing errors will go a long way toward implementing protocols and procedures to prevent them from happening in the future. Procedural Issues That Can Cause Billing Errors The following are common procedural issues that can occur in-house, which increase your risk of experiencing claim denials and delays in your practice’s revenue [...]
What Is A Charge Entry & Auditing For Medical Billing?
Several serious factors can interrupt the revenue stream of any practices. This includes things like persistent claim denials, a patient contesting charges, improper security protocols for HIPPA compliance, and medical coding errors. While some of these might be honest mistakes, they are often the result of an overtaxed or undertrained administrative task. The truth is most medical administrative support staff are better off handling other tasks within the practice rather than losing precious man-hours to medical coding and chasing [...]
