Patients over Paperwork Initiative: Explained You most likely have heard of the Patients over Paperwork Initiative by now and may be wondering what exactly it is. To simplify, the Centers for Medicare and Medicaid Services started the initiative this year to reduce the many administrative requirements that were complicating the process of providers working with [...]
Medical Necessity
Definition of Medical Necessity A physician or clinical provider of care may have a completely different understanding, interpretation, and definition of medical necessity than the patient or a third-party insurance payer. Medical necessity documentation from a physician or provider should include the following: • Severity of the “signs and symptoms” or direct diagnosis exhibited by [...]
Medicare
Chiropractors may not OPT OUT of Medicare. You can choose to be par or non-par which means you must file your claims per “Mandatory Claim Submission Rule”, you can still be audited, and there is a 5% difference in reimbursement. If you are non-par and accept assignment on the claim form you must report what [...]
Active Rehabilitation
One of the most commonly asked questions we hear as a billing company is, "When do we bill for 97110 code (therapeutic exercise) versus 97530 (therapeutic activity)". Although very similar in terms of long term goal achievement for the patient, there are differences. Therapeutic exercises are often executed along with therapeutic activities. For example, [...]
Should You Outsource Your Billing?
Besides costs, there are other factors that would spur a provider to consider outsourcing their billing. Your billing process is inefficient. If your collections have decreased and your billing staff insists that they are not changing the process of billing and follow-ups you may want to consider outsourcing RFS Billing and Consulting. We will decrease [...]