On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), which amended the time period for filing Medicare fee-for-service (FFS) claims as one of many provisions aimed at curbing fraud, waste, and abuse in the Medicare program. The time period for filing Medicare FFS claims is specified in [...]
State and federal laws require that most payors pay clean claims within specific timeframes. California law further requires health plans and insurers to pay interest on claims that are not paid within the required timeframe. Payor Type Timeframe for Payment Penalty HMOs and their contracting medical groups/IPAs 45 working days Non-emergent – 15% of amount due [...]
The Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners and other providers of services paid under the Medicare physician fee schedule. Congress is working to avoid the [...]
CMS has deleted the consultation codes in 2010. This has created a lot of questions for the healthcare providers, specifically the specialists. The following Q&A will aid you with some of the common questions: Will these new changes decrease your revenue? If compared at the same CPT level e.g. 99243 versus 99203, the effect will be negative. However, the [...]
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