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Refresher: Guidelines for E/M Coding  

Hard to believe that the new E/M guidelines have been in place for urgent care for four years.  These guidelines...

Feb Industry Notes: Medicare Updated MBIs/Member IDs Causing Rejections 

According to a CMS press release, a security vulnerability in the MOVEit software used by Wisconsin Physicians Service Insurance Corporation (WPS)...

How To Register a Medicare Beneficiary  

At the end of every year, Medicare beneficiaries pick the insurance they want for the next year at open enrollment....

What’s New in Telemedicine for 2025? 

The American Medical Association (AMA) added a Telemedicine Services category to the Evaluation and Management section of CPT. Codes are...

Nov Industry Notes: UHC – New GA Modifier Requirements 

Beginning Feb. 1, 2025, UHC is adding the following GA modifier requirement for their commercial plans. If you know or...

Nov Industry Notes: Ohio – Four Managed Care Plans Selected for Next Generation MyCare Plans 

On November 1, the Ohio Department of Medicaid (ODM) announced four managed care organizations to serve as the Next Generation...

Payer Contracts: Looking Forward to 2025 

We blinked and it is November already. Holy Smokes! We are deep into the fourth quarter of 2024 and you...

How Does Data Reviewed Work When Coding E/M? 

Amount and/or Complexity of Data to Be Reviewed and Analyzed is one of three elements that determine the level for...

Sept Industry Notes: EOBs during the Change Healthcare Service Outage 

CDPHP: Issuing of EOBs during the Change Healthcare Service Outage  As a result of the Change Healthcare security issue and...

Sept Industry Notes: Sanford Health Plan

Sanford Health Plan: Change of Mailing Address  Sanford Health Plan has changed the mailing address for Medicare Advantage claims submitted...

Navigating Diagnosis Denials

RCM Operations Director: Brianna Crowley A growing concern in the healthcare system is the increased amount of diagnosis denials. Insurance...

ICD-10-CM: What’s New for 2025

How are we preparing for the end of year already? Didn’t 2024 just begin? Unfortunately, we are heading into fall...

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