Problem: A quarterly audit for an independent Southern pathology lab unveiled the lab received $31.94 less for its global 88305 CPT codes (a microscopic tissue examination to provide diagnosis) than its contracted rate with a large commercial insurance carrier allowed...
During the past five years, we have seen many billing companies lower their cost for services. When this trend is examined, it becomes apparent that the lower cost is available because these billing services are offshoring their services. As medical billing companies...
Anthem BCBS takes a cue from CMS regarding payments for clinical pathology New rules look at modifier and place of service, essentially cutting payments Billing for anatomic pathology is unchanged The states of Indiana, Kentucky, Missouri, Ohio and Wisconsin are...
It seems our latest audit has caught a glitch in Medicare Immunohistochemistry (IHC) payments. We found that Cahaba GBA, which serves as the Medicare administrative contractor for Alabama, Georgia, and Tennessee, is denying claims for CPT code 88341 as multiples,...
By Jessica Jankowski, Senior Practice Manager Vachette Pathology Since January 2014, there are more and more issues coming out of the woodwork with FSH billing and reimbursement. Earlier this year, we saw United Health Care (UHC) create their own application of an...
By: Mick Raich, former President, RCM Solutions We have worked with 86 different revenue cycle entities over the past 12 years. From hospital CBO’s to large national firms to small firms with only two clients. There are certain trends we see whenever a billing firm...
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