Telehealth billing splits by payer. Set place of service and modifier from the visit, handle audio-only correctly, and confirm each payer’s rule first.
Telehealth Billing After the Flexibilities: Modifier and POS Rules Read More »
A medical necessity denial is decided by the note, not the diagnosis. What payer reviewers look for and how to cite LCD and NCD language on appeal.
Medical Necessity Denials and the Documentation That Prevents Them Read More »
Medicaid provider enrollment runs on 50 state systems with different fees, revalidation cycles and group rules. How to plan a multi-state rollout.
Medicaid Provider Enrollment: Why State Timelines Differ Read More »
Waiver services bill through their own authority, provider number and authorization. How HCBS claims are set up for a behavioral health practice.
Medicaid Waiver Billing: HCBS for Behavioral Health Read More »
Locum tenens billing with modifier Q6: how the 60-day clock runs, what goes in item 24D and 24J, the file a MAC asks for, and who cannot be billed this way.
Locum Tenens Billing: Modifier Q6 and the 60-Day Rule Read More »
Modifier 24 pays an E/M inside a surgical global period only when the note proves it was unrelated. The documentation test and how payers read the pattern.
Modifier 24: Billing an E/M During a Global Period Read More »
RPM billing splits into setup, device supply and treatment management. Here is the consent rule, the 16-day data test and the records payers review.
Remote Patient Monitoring Billing: Codes, Consent, 16 Days Read More »
Most preventable denials start at registration. The five front-end checks, what each one prevents, and what a reworked claim actually costs a practice.
Front-End Denial Prevention: 5 Checks Before the Claim Read More »
Group therapy billing turns on three checks: the code that matches the room, the unit the payer allows, and an attendance record that names every patient.
Group Therapy Billing: Units, Attendance and Documentation Read More »
How to sample charts by provider and code family, score errors against Medicare’s five CERT categories, and turn the findings into fewer denials.
Internal Coding Audits: Sampling, Scoring and Follow-Up Read More »
