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    Welcome to the ClaimCare Medical Billing Blog. We strive to provide content that improves the overall quality of medical billing efforts across the US. If you have any specific topics that you would like to see addressed in this medical billing blog please post the topic in the Medical Billing Questions & Answers Forum. If you have an article that you would like considered for publication in the medical billing blog then please email your article to resources@claimcare.net.

    MEDICAL BILLING BLOG

    What Does Today's (5/11/2023) End of the COVID PHE Mean for Providers?

    Posted by Carl Mays, ClaimCare President/CEO on Thu, May 11, 2023 @ 02:02 PM

    Medical Billing ExpertsThe Biden Administration is ending the COVID19 Public Health Emergency May 11, 2023. This blog is intended to assist you with that transition which includes important coding andImpact of the Proposed 2019 Medicare to the Medical Billing of Ambulatory Surgical Center Services billing items that will change because of the end of the PHE. Even if you believe that you are no longer involved in the treatment of or diagnostics for COVID, if you are doing any kind of remote patient care, laboratory, or Telemedicine then you will need this information moving forward. It is hard for a medical provider to be Medical Billing Experts on all relevant topics. ClaimCare is here to help. 

    ClaimCare Medical Billing Services has remained diligent in our billing efforts, compliance efforts, and client direction, to ensure that our clients have been reimbursed the maximum amount allowable. At the beginning of the Pandemic, we encouraged all of our clients to perform eligibility prior to services being rendered. That process should remain in place. Eligibility issues will continue to be a priority, so we encourage you to monitor that process going forward and ensure it is being fully utilized in your workflow.

    Major bullet points that will impact your practice and/or COVID related business going forward:

    • Telehealth Services
      • Telehealth services will continue to be allowed through the end of 2023. CMS expects to continue this service to Medicare Recipients as it has proven to enhance patient outcomes. Providers should continue to use CPT codes as if they were in person visits with modifier 95 to indicate services were delivered via telehealth.
      • Telehealth does NOT require video beyond the pandemic if the patient does not have a smart phone or computer.
    • COVID Treatment
      • COVID Vaccines are still covered 100% with no patient co-insurance/deductible. Do NOT use the CR modifier after May 11th.
      • COVID Booster still covered 100% with no patient co-insurance/deductible. Do NOT use the CR modifier after May 11th.
      • Treatment via oral anti-viral will continue to be covered without patient co-insurance after May 11th Do NOT use the CR modifier after May 11th.
      • Private Insurance is required to cover Vaccines and treatment for COVID19 with no co-insurance. Do NOT use the CR modifier after May 11th.
      • Diagnosis coding for COVID related services should still utilize ICD-10 Z20822
    • COVID Testing
      • After May 11th, all testing must be ordered by a physician or other eligible provider.
      • Lab U0003, U0004, and U0005 will not be covered beyond May 11th. Revert to the usual PCR testing. You should choose the test that best describes the actual test you run.
        • Most Labs do not report a range (quantitative results) It is typically reported as a positive or negative. In this instance, it is recommended that you choose 86413 if you DO report quantitative results. If you do NOT report quantitative result, choose 86769. (this is for PCR testing only) Refer to the actual lab test that you report on to choose the closest CPT code for the test you bill.
      • Labs are no longer required to report to CDC after May 11th.
      • Labs are no longer required to post prices on their website for price transparency beyond May 11th.
      • G2023 and G2024 will no longer be covered (lab specimen collection) beyond May 11th.
      • 99211 will no longer be utilized for specimen collection beyond May 11th.
      • Over the Counter COVID Tests will no longer be covered beyond May 11th except for Medicaid plans. Medicaid plan members will be able to obtain OTC COVID tests through December 2023.
    • Miscellaneous
      • Virtual Supervision stays in effect through the end of 2023.

    Please reach out to the ClaimCare team if you have any questions.

    ClaimCare has 30 years of medical billing experience. We have an established 100% USA-Based medical billing team that has been assembled through a thorough pre-employment screening. All personnel participate in on-going training and strong process management to ensure they deliver only the highest quality medical billing services to clients.

    ClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.” The honor this time comes from MD Tech Review. The magazine’s Augmenting Medical Billing and Coding Operations article presents solid reasons why ClaimCare has been chosen for this 2021-2022 recognition. 

    For more information, contact sales@claimcare.net, or phone toll-free at (855) 376-7631, or visit the ClaimCare Medical Billing Company website. We can assist your practice and/or facility in numerous ways, including complete credentialing processing.

    Tags: CMS Update, telemedicine, Center for Medicare and Medicaid Services, CARES Act, COVID

    Provider Relief Fund Deadline Extended to August 3

    Posted by Carl Mays, ClaimCare President/CEO on Mon, Jul 27, 2020 @ 06:30 AM

    Provider Relief Fund Deadline Extended to August 3

    covidimage

    It’s not too late to apply for financial emergency assistance from the Provider Relief Fund if you have not yet done so. The deadline to apply has been extended to Monday, August 3.

    For in-depth information from HHS about this extension, visit CARES Act. Included with the latest update on the application process is information about a webcast on Monday, July 27, 2020 at 3:00 p.m. ET.    

    You may also want to revisit an earlier ClaimCare blog concerning Four Options to Boost Your Practice’s Cash on Hand Balance.  

    Another site of interest in this matter is HealthCare Law Diagnosis.

    Meanwhile, we have discovered through our clients that some patients, especially senior adults, remain hesitant about going into a medical office or facility since COVID-19 is on the upswing in certain areas.

    Therefore, being proficient in telemedicine is still highly important. We have posted several earlier blogs regarding telemedicine, which include:

    Keep Revenue Flowing During Pandemic (03-27-20)

    Serving Patients Through Telemedicine (03-31-20)

    Update to Telemedicine (04-03-20)

    Also, regardless of the state in which you have your practice or facility, here is an informative and very extensive article by the Texas Medical Association about telemedicine and more.

     

    About ClaimCare ®                        

    ClaimCare has 30 years of medical billing experience. We have an established 100% USA-based medical billing team that has been assembled through a thorough pre-employment screening. All personnel participate in on-going training and strong process management to ensure they deliver only the highest quality medical billing services to clients.

    AwardclaimcareClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.” The honor this time comes from MD Tech Review. The magazine’s Augmenting Medical Billing and Coding Operations article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition.

    For more information, phone (855) 376-7631 toll-free, or contact sales@claimcare.net, or visit the ClaimCare Medical Billing Company website. We can assist your practice and/or facility in numerous ways, including complete certification processing

     

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    100% USA-Based HIPAA-Compliant Medical Billing Company

     

     

     

    Tags: HIPAA, best medical billing companies, telemedicine, CARES Act, Healthcare Cash Flow, Provider Relief Funds Extension

    Practice Cashflow Update April 1, 2020

    Posted by Carl Mays, ClaimCare President/CEO on Thu, Apr 02, 2020 @ 08:00 AM

    Four Options to Quickly Boost Your Practice’s Cash on Hand Balance

    CashFlow

    As patient volumes have fallen, many practices are worried about keeping their doors open through this national COVID-19 crisis. With that in mind, the goal of this update is to outline four options at your disposal to quickly increase your available cash balances. These have all been made available or made easier to pursue by recent government changes in reaction to the economic turmoil being caused by COVID-19 and the related “shelter in place” orders around the country. These are listed in the order from fastest to slowest in terms of increasing your available cash on hand. 

     

    • Apply for Medicare’s Accelerated Payment and Advance Program
    • Apply for the Paycheck Protection Program as soon as it is open for applications
    • Aggressively pursue telemedicine
    • Apply for a Small Business Administration (SBA) Economic Injury Disaster Loan                            

    Details and key links for these options

    1.  Apply for Medicare’s Accelerated Payment and Advance Program.
          This program will advance you up to three months of your normal monthly Medicare payments.      

          Key elements of the program:

      • You will have the money within seven business days from when you apply.
      • You will not owe anything on this money for the first 120 days, AND your claims being sent to Medicare during this time will still pay as normal.
      • You will begin having the advance recouped after 120 days.
      • Please see this blog on ClaimCare’s website for more detailed information about the program: Medicare Accelerated Payment and Advance for Providers.  

    CMS_expands_financial_relief_for_Medicare_Providers_pic___3.31.20du___virus_4970581_1920___Pixabay.5e835a4f8b198

    2.  Apply for the Paycheck Protection Program 

          Key elements of the program:

    • It should be live for applications by Friday, April 3rd.
    • The money should be in your account in two weeks or less.
    •  It will be administered by banks and not the SBA.
      • You can receive a loan of up to 2.5 times your monthly payroll.
      • No payments are owed for the first 6 months, and no payments will be owed at all if you meet the guidelines for full loan forgiveness.
      • For the loan to be forgiven you need to use it within the eight weeks after the funds are received to pay for employee salaries, rent, utilities and other similar expenses. You also need to maintain your payroll and not significantly reduce it through layoffs or wage reductions.
      • Here is a link to more information about the program: SBA Paycheck Protection Program.

    3.  Aggressively pursue telemedicine.

    We have released multiple updates on this. The bottom line is that the reimbursements have increased, while the amount of required paperwork and other requirements have decreased; and the scope of what can be done with telemedicine has expanded. Please follow these links to see our latest updates on the ClaimCare Blog:

    4.  Apply for a Small Business Administration Economic Injury Disaster Loan.

    These loans are available because a state of emergency has been declared. These loans will take longer to result in cash on hand than the first three options outlined, but they also allow for a loan amount of up to $2 million. These are different than normal SBA loans and the lending rules are more lenient.

         Key elements of the program: 

    SBA-Loan-1030x687
    • These loans are administered by the SBA.
      • You can borrow up to $2 million.
      • You can receive an almost immediate advance of $10,000.
      • All businesses in all states are now eligible for these loans.
      • The loan proceeds can be used for expenses that cannot be paid because of the COVID-19 economic disaster.
      • The interest rate will be 3.75%.
      • You will have up to 30 years to repay the loan.
      • None of this loan is forgivable.
      • Here is a link to the SBA Economic Disaster Loan Application.

    As you can see, you have four great options to quickly improve your current cash position and help sustain you through this economic crisis. Rest assured that ClaimCare, with our fully HIPPA-compliant 100% USA-based  work from home team, is focusing on every lever at our disposal to quickly bring money in from our clients' existing and new claims.

    We encourage you to reach out to your practice’s banker to get more information about the loans outlined above. Please let ClaimCare know if you are in need of a professional medical billing company to become your partner and help you during this COVID-19 crisis - and beyond. Our mission statement is "To collect the maximum revenue for your practice as fast as possible while helping to alleviate costs and hassle for your organization" 

     

    About ClaimCare

    ClaimCare is a 100% USA-based HIPAA-Compliant Medical Billing Company

    ClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.”  The honor this time comes from MD Tech Review.  The magazine’s Augmenting Medical Billing and Coding Operations article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition.

    For additional information, contact sales@claimcare.net, or phone toll-free (855) 376-7631, or visit the ClaimCare Medical Billing website.  We can assist your practice and/or facility in numerous ways.

    Tags: Physician Reimbursement, COVID-19 Medical Reimbursement, telemedicine, SBA Loan, Practice Cash Flow

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