Insurance – CRN Healthcare Solutions

New Patient E/M Denials: Mystery Solved

January 21, 2020June 28, 2022Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

New patient evaluation and management (E/M) claims are being denied when the patient was previously seen by a specialty physician assistant or specialty nurse practitioner on staff. This is happening when another provider of a different specialty in t… For more, read here: AAPC Blog

Multiple Endoscopy Rule Examples

January 13, 2020June 28, 2022Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

In my last blog “Special Rules Apply to Endoscopic Sinus Surgeries,” I discussed the change to the Multiple Endoscopy Rule for multiple surgeries when performed within the family of endoscopic sinus codes. How Does the Multiple Endoscopy Rule Affect … For more, read here: AAPC Blog

Anthem Changes Timely-Filing Deadlines

August 5, 2019December 4, 2020Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Anthem has sent out a notice to all providers who have signed non-Medicare or Medicare Advantage contracts with them, stating: “Effective for all commercial and Medicare Advantage Professional Claims submitted to the plan on or after Oct. 1, … For more, read here: AAPC Blog

Reporting Bilateral Services: Conflicting Information Causes Confusion

July 29, 2019December 4, 2020Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Payer-specific rules — especially rules that vary for every claim — not only make collecting revenue difficult, but also add to the cost of collection of monies earned by the physicians. A blog clarifies Novitas’ instructions for reporting modifier … For more, read here: AAPC Blog

98point6 Wants to be Amazon Prime of Primary Care

February 12, 2019March 13, 2019Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

A Seattle company looks to make primary care as easy as buying something off of Amazon.com. 98point6 is a Seattle start-up brain child of Rob Schwietzer who scaled Amazon Prime from thousands to millions and CEO Robbie Cape from Microsoft. 98point6 … For more, read here: AAPC Blog

Medicare Part D Prescription Drug Model to Change in 2020

January 25, 2019January 31, 2019Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

There are big changes on the horizon for the Medicare Part D prescription drug model, and they’re going to affect medical coders. The current reimbursement system and payment model for Part D creates incentives for plans to push patients to the … For more, read here: AAPC Blog

Technology Outlook in Health: 2019

January 14, 2019January 31, 2019Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

A lot of things are happening on the technology front in healthcare. These changes will impact medical coding and billing, compliance, and practice management. Health Technology – Amazon It starts with Amazon’s announcement that they are going to join… For more, read here: AAPC Blog

Recognize the New MBI

September 4, 2018September 7, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

MLN Matters issued an article on July 11, 2018 to clarify that the Medicare Beneficiary Identifier (MBI) format does not use the letters S, L, O, I, B, and Z. This was done so that there will never be a confusion between the numbers 5, 1, 0, 3, and … For more, read here: AAPC Blog

Coverage Expands as Six Health Systems Combine

April 17, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Borrowing a page from the plan announced by Amazon, JP Morgan Chase, and Berkshire Hathaway, six healthcare systems in New Jersey are joining their work forces to expand coverage to 50,000 employees and dependents under a single self-insured health … For more, read here: AAPC Blog

Blue Cross of Mich. Reverses Decision

April 12, 2018August 28, 2018Barbara Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCONo Comments

Blue Cross Blue Shield (BCBS) of Michigan is delaying their planned non-coverage of hyaluronic acid injections for knees, slated for April 1. BCBS Pulls Up BCBS giving themselves time to study if hyaluronic acid has the true medical benefit that it c… For more, read here: AAPC Blog