Medicare 2024 Physician Fee Schedule Proposed Rule Key Points On July 13th, the Centers for Medicare and Medicaid Services (CMS) published the 2024 Medicare Physician Fee Schedule proposed rule (PFS) which includes proposed Medicare Part B payment policies for the coming calendar year.  CY 202...

Invalid Member Name, Date Of Birth or Identification Number     Insurance claim rejections and its followup Invalid member name, date of birth or identification number Policy canceled or coverage terminated Invalid or obsolete ICD 10 diagnosis code Non specific ICD code posted for CPT 9330...

E&M code updates of 2021 Medicare and Medicare Advantage plans are adopting the new E&M codes starting from 01/01/2021. However commercial insurances usually follow CMS and AMA guidelines, they are not required to adopt the new changes.   Key takeaways 99201 and 99211 are obsolete for 202...

How to avoid Medical Records request from UHC United Healthcare requests medical records for most of the claims. After our deep analysis we found that if the total claim charge amount is more than $1,300 UHC is requesting medical records. We tried two claims for different patients with the same proc...

Fee schedule analysis and auditing                     The insurance allowed amount or the fee schedule is determined by various factors such as insurance plan, provider in-network or out of network status, ACO, PHO, geographic practice cost index, etc. If the practice did not keep up with...