Accurate Coding for Vaccines | 90471, 90472 and more|

From flu to tetanus, and now COVID-19, vaccines are among the most common outpatient procedures providers administer on a day-to-day basis. But they can also be complex to code and bill, and undetected mistakes can result in continual underpayment for services rendered.

a doctor filling out a form on a clipboard

Navigating Medi-Cal

Completing Medi-Cal forms can be challenging. Knowing what form to use based on the scenario and the time of request is important. There is also an alternative to the handwritten requirement.

PAMA Reporting Regulations and Penalties

The PAMA law brought a wide variety of changes to Medicare, including the method by which Medicare will calculate the rates it will pay under the Clinical Lab Fee Schedule. Data collected from the period of Jan. 1, 2019-June 30, 2019, must now be reported to Medicare between January 1 and March 31, 2022 or potentially face fines of more than $10,000 per day.

Portrait of a sick patient coughing into tissue being helped via tele medicine by a male doctor wearing blue scrubs uniform using laptop

Take Steps to Stay Abreast of Evolving Telehealth Reimbursement

The use of telehealth has skyrocketed due to the COVID-19 pandemic. However, long-term uncertainty about Medicare reimbursement and wide disparities in the way commercial payers and Medicaid programs reimburse for telehealth mean providers must be extra-vigilant to limit denials and underpayments. Financially hard-hit providers must consider new revenue cycle management protocols to ensure the best chance for full reimbursement.

Hospitals Can Improve Collections by Targeting CARC 24 Denials

Hospitals can quickly and dramatically improve collections by reducing Claim Adjustment Reason Code (CARC) 24 denials, or claims rejected due to incorrect Medicare and Medicaid submissions.