Billing and Reimbursement for Ambulance CPT Codes and Modifiers A0425, A0426, A0427, A0428, A0429, A0432, A0433, and A0434
RPM Billing LLC Blog
by Jonathan Marshall
2y ago
Ambulance and emergency services are billable events, and all insurance companies including Medicare and Medicaid pay for them.  Coding and billing for ambulance services can be complicated because of the unique and detailed modifiers, and the various modes of transport include ground, water, fixed wing, and rotary wing.  RPM Billing LLC has certified ambulance billers and coders on staff, and we are committed to working closely with our clients to provide excellent service and results in ambulance billing and coding.  This blog is intended to provide helpful information for pe ..read more
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Is Your AR "Streaming"?
RPM Billing LLC Blog
by Jonathan Marshall
2y ago
If you’re like most healthcare providers, you have a nagging concern: is my billing service giving me the bandwidth I need to be successful? In other words, does your billing service proactively work with you and your team to understand your business and then give you the resources needed in order to keep your AR moving and get it collected? Or are you just fitting in to their profit-taking formula? Billing services are famous for controlling their own costs after landing new clients, focusing on the easy billing in order to keep their profit margins high. Unless you are consistently driving ..read more
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Healthcare Billing and the Revenue Cycle – It Works like a Factory
RPM Billing LLC Blog
by Jonathan Marshall
2y ago
RPM Billing provides excellent healthcare billing and revenue cycle management services to its clients. The “revenue cycle” is a set of key clinical and administrative processes, which occurs in a coordinated fashion alongside each patient’s service, and ultimately collects all of the data needed in order to bill for that service. Important data elements that are needed for billing, such as the patient’s name, address, gender, birth date, insurance information, services rendered, and diagnostic codes are gathered in the revenue cycle. Think of the revenue cycle as a series of inputs, and bill ..read more
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Successful Clinic Operations for “Incident To” Billing
RPM Billing LLC Blog
by Jonathan Marshall
2y ago
Many physicians hire mid-level providers, such as Physician Assistants and Nurse Practitioners, to work in their practice as a way to expand capacity and provide more services to more patients. However, services provided by mid-levels are typically paid at only 85% of the rate that would have been paid had the physician provided the service instead. “Incident To” billing exists as a way to acknowledge the physician’s active role in the patient’s care, and when supervised mid-level services are billed as “Incident To”, they are reimbursed at 100% of the physician rate instead of being subject ..read more
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A Brief Outline of Billing and Reimbursement Topics for Physician Office Laboratories
RPM Billing LLC Blog
by Jonathan Marshall
2y ago
Physicians across the country operate in-office laboratories and do billing for certain types of lab tests.  For example, pain management physicians use this service to do drug testing on patients in order to get faster results while increasing their revenue per patient.  Urinalysis testing can be done using a simple dipstick, or it can be done more thoroughly using analyzer machines.  The dipstick method is cheaper, faster, uses no technology, but is also more likely to produce inaccurate results.  When using the analyzer machines, each sample is typically run twice, once ..read more
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Billing and Reimbursement for CPT Code 96146 and related codes (formerly 96103) – Computer-Based Psychological Tests
RPM Billing LLC Blog
by Jonathan Marshall
2y ago
Computerized psychological testing is a billable event formerly using CPT code 96103.  Many providers have increased revenues, and improved service to patients, by providing this testing service in their clinics.  Almost all insurance companies paid for this service, and in our experience the average reimbursement for CPT code 96103 was between $30 and $75.  The definition of CPT code 96103 and its requirements were as follows: Psychological testing (allowing a variety of issues including emotional, intellectual abilities, personality, psychopathology, MMPI, etc.), administered ..read more
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Helpful Guide for Billing the Cares Act for Covid Testing and Services
RPM Billing LLC Blog
by Jonathan Marshall
3y ago
This guide includes and summarizes helpful information and links about billing the Cares Act for Covid testing, including the following questions: -          What are the billing codes for the COVID PCR tests - nasal, oral, saliva? -          What are the billing codes for Rapid Antigen and Rapid Antibody? -          What is the expected reimbursement amount for the various tests? Providers who conduct COVID-19 testing (or provided approved treatments or vaccin ..read more
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Insurance Contract Negotiations: Improving Provider Reimbursement
RPM Billing LLC Blog
by Jonathan Marshall
4y ago
Healthcare providers can improve their reimbursement rates and other key terms by successfully carrying out an insurance contract negotiating strategy.  RPM Billing has an excellent track record of successful insurance contracting strategies for many different healthcare providers in markets across the country.  Commercial insurance plans frequently pay different in-network providers using different rates within a range that is specific to each market.  Insurance plans very rarely offer providers rates that are at the high end of the market range, and many providers are in a hurry to get paid ..read more
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