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Medical Billing
Health plan insurance coverage gives people peace of mind when an unexpected medical event happens. As we have all experienced, life can be unpredictable, and we have learned the precious value of having good health. Doctors, nurses, and medical staff are on the frontlines daily to help patients achieve and maintain good health. Behind the…
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Re-enrollment and social health equity are the focal points of community health plans across the United States as they tackle important hurdles to health for millions of the nation’s patients. With the end of the Public Health Emergency (PHE) looming on July 15th, even with a potential extension to October, Medicaid members could see a…
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Industry conferences generally illuminate growing trends and broad, often brilliant ideas. Distinguished presenters glide through slides and issues providing probable causes and ideal answers. One can almost feel the enthusiasm ricocheting off the walls of Ballroom A… We’re going to make it after all!
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It is an all too common occurrence: a motorist is seriously injured in a car accident and requires emergent treatment. According to the National Safety Council, nearly 6,300 people sustain serious injuries every day in the U.S. due to motor vehicle accidents1. Most of these people are immediately transported to the nearest hospital for care.…
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Nokomis Health’s coding team was reviewing a client’s out of network laboratory and a batch of genetic testing claims raised some questions. The claims appeared to be legitimate – the CPT code was valid, the diagnosis code supported the charge, the NPI and TIN were correct – but the charges were very high for the…
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Do you know how much power there is in a single two-digit number? Most payors and health plans don’t realize the impact that the 59 modifier can have on claim costs. Adding this simple modifier to a CPT code allows that code to bypass several code edits, resulting in erroneous and often incorrect payments. Providers have…
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