Texas OB-GYN Billing: Recover Medicaid Managed Care Underpayments Before the Filing Deadline

-
Image
OB-GYN practices in Texas are losing significant revenue due to Medicaid managed care underpayments that go uncorrected before filing deadlines expire. These underpayments often remain hidden within high claim volumes, and without proactive follow-up, they turn into permanent revenue loss. Texas has one of the largest Medicaid populations in the country, with multiple managed care organizations (MCOs) administering benefits. While this expands patient access, it also introduces complexity in reimbursement. Each payer applies different fee schedules, edits, and payment rules, making it difficult to track whether claims are paid accurately. This is why many providers rely on specialized OB-GYN billing services and medical billing services in Texas to identify and recover lost revenue. Why Medicaid Managed Care Underpayments Occur Underpayments typically happen when payer systems apply incorrect fee schedules, misinterpret coding, or bundle services that should be reimbursed separa...
Post a Comment

Declaration of Blanket Waivers for SNFs

-

declarationofblanketwaiversforsnfs.jpg

On 7th April 2022, in response to the COVID-19 PHE and under section 1135 of the Social Security Act, CMS passed several temporary emergency declaration blanket waivers which were intended to provide health care providers with extra flexibilities required to respond to the COVID-19 pandemic. While the waivers of regulatory requirements have provided flexibility in how nursing homes may operate, they have also removed the minimum standards for quality that help ensure residents’ health and safety are protected. 

Declaration of Blanket Waivers

Recently, CMS conducted some surveys that revealed significant concerns with resident care that are unrelated to infection control (e.g., abuse, weight loss, depression, pressure ulcers, etc.). Waiver of certain regulatory requirements may have contributed to these outcomes and raised the risk of other issues. For example, by waiving requirements for training, nurse aides and paid feeding assistants may not have received the necessary training to help identify and prevent weight loss. Similarly, CMS waived requirements for physicians and practitioners to perform in-person assessments, which may have prevented these individuals from performing an accurate assessment of the resident’s clinical needs, contributing to depression or pressure ulcers. As a result, CMS has terminated certain waivers.

In this blog, Our Medical Billers and Coders shared emergency declaration blanket waivers for certain providers in SNFs. Looking for more information about Declaration of Blanket Waivers for SNFs click here: https://bit.ly/3xJKyyU. also you can get in touch with us at info@medicalbillersandcoders.com or call us at 888-357-3226.


Location: United States

Comments

Post a Comment

Popular posts from this blog

How to Reduce Days in A/R with Smart Denial Management Strategies

-
Image
 Timely reimbursement is the lifeblood of a financially healthy medical practice. Yet, increasing Days in Accounts Receivable (A/R) continues to be one of the most pressing revenue cycle issues for healthcare providers. One of the major culprits behind this issue? Denials. In this blog, we explore how strategic denial management not only reduces days in A/R but also improves cash flow and strengthens your bottom line. Understanding Days in A/R Days in A/R refers to the average number of days it takes for a practice to collect payments due after services have been provided. Industry benchmarks typically suggest keeping A/R days under 35. Anything higher signals inefficiencies - and likely unresolved denials. How Claim Denials Affect A/R Denied claims delay payments and increase administrative burden. Without an effective process to identify, appeal, and correct them, your A/R days will climb - and revenue will suffer. Top causes of denials include: Missing or incorrect ...
Read more

How Outsourced Medical Billing Can Improve Your Practice’s Profitability

-
Image
Managing a medical practice comes with its fair share of challenges—from patient care to staffing and compliance. But one of the most overlooked factors impacting a practice’s financial health is inefficient billing . That’s where outsourced medical billing comes in—not just as a cost-cutting solution, but as a profitability booster . Here’s how outsourcing your medical billing can significantly improve your bottom line. 1. Reduced Administrative Costs Running an in-house billing department requires trained staff, billing software, continual updates, and compliance oversight. These overhead costs can add up quickly. Outsourcing eliminates the need for these expenses, allowing you to pay only for the services you use —often at a fraction of the cost. 2. Faster Claim Submission and Reimbursement Professional billing companies are equipped with experienced teams and advanced tools that ensure quick and accurate claim submission . This minimizes delays and accelerates cash flow , g...
Read more

Is Your Neurology Billing Outsourcing Helping or Hurting You at Year-End?

-
Image
  As year-end approaches, neurology practices face a crucial decision: Is your billing outsourcing truly improving your financial performance, or silently affecting your revenue? Neurology billing is complex due to time-based coding, modifier usage, high documentation requirements, frequent audits, and prior authorization challenges. If your billing partner lacks neurology-specific expertise, it may lead to claim denials, revenue loss, and compliance risks. Signs Your Neurology Billing Outsourcing Is Helping If your billing partner is performing well, you will see: • Reduced denial rates for neurology codes (EEG, EMG, Botox, Nerve Conduction Studies) • Faster reimbursements and fewer delays from payers • Active recovery of old AR beyond 60, 90, or 120+ days • Accurate CPT, ICD-10, and modifier usage for neurology procedures • Clear billing reports, denial analysis, and revenue insights • Compliance with Medicare, commercial payers, and documentation standards Warning ...
Read more