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

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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...
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Durable Medical Equipment Billing: Steps to Follow

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Durable Medical Equipment Billing is different from the other medical billing and coding for the specialties. Unlike the other coders and billers who work on DME need specialized training to deal with different medical situations and equipment that require different types of modifiers as requested.  DME billers need specialized in-depth, specialized knowledge of different types of HCPCS Level 2 codes.

Let’s understand the procedures of coding that can be implemented to make the billing process more effective:

  • ICD-9 codes are 3-5 digits in length and speak to the patient’s conclusion
  • CPT restorative charging codes are in fact HCPCS Level I codes. They are 5 digits in length and speak to the methodology performed at the patient’s visit
  • HCPCS codes are in fact HCPCS Level II codes. They incorporate the two numbers and letters and are likewise 5 digits in length. These codes speak to the majority of the provisions or gear utilized in the patient’s consideration.

All Durable Medical Equipment is arranged under HCPCS Level II. In that capacity, these are the main codes you will use as a DME biller or coder.

Durable equipment must be recommended by a restorative specialist, found therapeutically important, and afterward affirmed by the patient’s insurance agency. At exactly that point the hardware is given to the patients.

Along these lines, the strong medicinal hardware charging and coding processes are substantially more convoluted than ordinary charging and coding.

To know more about the Step by step durable medical equipment billing guide click here: bit.ly/3ybXTQi  Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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