Blue Cross and Blue Shield of Illinois

And you are asking yourself, why should I care about Blues of Illinois since I do not live in Illinois. Unfortunately, United Airlines employees have Blues of Illinois, along with a few other large employer groups, who may come to see you. Also the Blues of Illinois guidelines have been adopted by Blues of Oklahoma, […]

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Medicare "Red Flags"

When billing to Medicare, there are a few issues of which you should be aware to ensure you are not sending claims that can create a ‘red flag’. With the new RAC audits that are coming, it is important to not send claims that can focus attention on your practice. Even if Medicare denies a […]

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Medicare Audit Changes

Due to new healthcare legislation designed to catch overpayments, Medicare recently ‘hired’ several different organizations to begin auditing Medicare claims. There are a number of items of which you should be aware as they can impact – in a very negative fashion – your practice. These organizations, generically called Recover Audit Contractors (RACs) are paid […]

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Billing 93965 with 93970

This multiple scan billing question has come up and caused a little controversy. Let me try to make it a little clearer. First the basics:93965 is defined as Non-invasive physiologic studies of extremity veins, complete bilateral study (e.g. Doppler waveform analysis with responses to phleborheography impedance plethysmography). This is a non-imaging study in response to […]

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Ultrasound Reimbursement

Decrease in Ultrasound Reimbursement Medicare has come up with a somewhat sneaky way to reduce your reimbursement for bilateral and unilateral duplex ultrasounds (codes 93970 and 93971). Here’s how: In 2006, Medicare implemented the Outpatient Prospective Payment System (OPPS) to curb facility based outpatient reimbursement which includes ultrasound services. Unfortunately for the individual physicians, Medicare […]

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Medicare and Affiliated Products

MEDICARE AND AFFILIATED PRODUCTS: There exists some confusion, both by the practice and by the patient, as to what Medicare or other Medicare related benefits a person may have. While this document will not solve all of the issues, we believe that some background information may be of use to you. Medicare: If a patient […]

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Summertime Blues

A concern many practices may face is a drop in patients during the hot summer months when wearing hose is no fun. There is, though, one group of potential patients who only want services done during the summer… school teachers. Because they have two to three months off between school years, school teachers typically have […]

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Practice Standards

Below are some practice guidelines for your consideration. Most of these are in regards to your receivables but there are a few operational guidelines as well. For phlebology practices, the number of claims that ‘age’ due to notes requests and denials will always be higher than the non-specialty standards noted below. 1. Visits without charges […]

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January/February Marketing Tip

MARKETING TIP: It is cold and flu season for the PCP’s so they are pretty busy this time of year. However, now is a good time to reach out to other types of providers. OB/Gyn practices can be a good source of referrals. Try to stop by and visit with the practice manager and the […]

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