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Billing / PODIATRIST BILLING
« Last post by isabelreyna on April 10, 2018, 10:00:55 PM »
 ??? I just been putting 59 on all my billing with more then one procedure and an office visit. Now I am question myself, if i been doing this incorrect.
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Thanks for sharing.
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Recently decided California case 

Al-Shaikh v. State Department of Health Care Services

http://www.courts.ca.gov/opinions/documents/A147939A.PDF

https://www.buchalter.com/wp-content/uploads/2018/04/California-Court-Endorses-Percentage-Billing-Fees-for-Medi-Cal-Providers.Brendel.pdf

This Opinion clarifies 42 Code of Federal Regulations section 447.10 (and, in turn, Welf. & Inst. Code, § 14040.5, subd. (b)). This regulation was misinterpreted by the DHCS’s Chief, the Administrative Law Judge, DHCS’s attorneys, and the Superior Court. They failed to appreciate the regulation’s meaning from its face, and there was no case law to rely on for an interpretation.

This Opinion goes further by clarifying the legality of percentage-based billing contracts. Percentage-based billing contracts are the rule among private practice healthcare practitioners. In speaking with healthcare billing consultants, I learned that these contracts are commonly misunderstood by the government agencies overseeing Medicaid. And such mistakes can have disastrous consequences for the naïve healthcare provider’s practice. If she or he capitulates to the government’s demand to switch to a fee-based billing contract, the practitioner’s business is changed significantly for the worse. And if she or he argues the point, a protracted legal battle ensues because there is no legal precedent to turn to.
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Billing / Re: GA Medicaid Reason code 0984
« Last post by PMRNC on April 06, 2018, 11:41:00 AM »
I agree with Michele, your probably not going to get any payment from Medicaid and cannot bill the insured.
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New! / Re: Revenue Cycle Management
« Last post by PMRNC on April 06, 2018, 11:39:38 AM »
Quote
ICD10 was implemented a year and a half ago.   ???

Meitsnay thinka datitsa offshorkay   :o ;)
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Billing / Re: GA Medicaid Reason code 0984
« Last post by HPATEL on April 06, 2018, 09:32:54 AM »
Georgia..

Medicare just changed their contractor to Palmetto GBA from CAHABA GBA.

Medicaid is denying claims this year. The reason is Medicare co-insurance is more than 20%. I don't know whom to contact. Because all the Medicare coinsurance which was crossover to medicaid, they are higher than 0.01 only. I don't understand. 
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New! / Re: Revenue Cycle Management
« Last post by Michele on April 06, 2018, 07:24:16 AM »


Plan ahead for ICD-10: Because coding will be more complex when ICD-10 takes effect, you want staff that is not the only current on coding, but understands the increased level of detail required by physicians; physician education is equally as important to ensure all necessary details are provided within the physician’s operative reports. Inquire with your software vendor to make sure they are ready for the conversion. Because hiccups are likely to occur, consider opening a bank line of credit.


ICD10 was implemented a year and a half ago.   ???
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Billing / Re: GA Medicaid Reason code 0984
« Last post by Michele on April 06, 2018, 07:22:04 AM »
In NY and many other states Medicaid does not cover the 20% coinsurance.  It is denied with a similar reason. What state is it for?  Is it possible Medicaid doesn't pay?
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Coding / Re: Orthopedic PA visits in a nursing home
« Last post by Michele on April 06, 2018, 07:19:51 AM »
You should look at codes 99304-99316.  99304-99306 are initial visits, 99307-99310 are subsequent, and 99315-99316 are discharges.
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New! / Re: Revenue Cycle Management
« Last post by PMRNC on April 05, 2018, 02:19:06 PM »
Here we go.. more from offshore  :o
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