by NCCA | Feb 27, 2025 | Billing
Courtesy of Physician Practices Specialists Listed below are some essential questions you must answer before deciding to use a q6 or q5 modifier. The first question is what’s asked most often. Can I use a locums modifier during the credentialing process? Using a...
by NCCA | Feb 26, 2025 | Billing, Insurance
The NCCA has received numerous questions and concerns regarding the Aetna SHP fee schedule for S8990. The NCCA verified with the SHP that it is a covered code. Many have asked why the fee schedule is different and how Aetna can not follow the 50% of eligible billed...
by NCCA | Jan 9, 2025 | Billing, Insurance, Member News
BCBSNC On July 29, 2024, Health Network Solutions notified providers via email that BCBSNC plans to require prior authorization for most physical therapy codes for its fully insured plans starting October 1, 2024. Since then, the effective date was moved to...
by NCCA | Dec 19, 2024 | Billing, Insurance
The updated codes for ICD-10 have rolled out. Time to locate the codes within your practice management software and update the data with the new code offerings after September 30, 2024. Be sure to inform all staff involved in charting, charge entry, or billing. Avoid...
by NCCA | Dec 5, 2024 | Billing, Insurance
Courtesy of Sheri Frost You cannot convert a patient to cash if their condition meets medical necessity based on the payer guidelines. If you do not receive the requested number of visits for prior authorization, then you must submit for more based on medical...
by NCCA | Nov 26, 2024 | Billing, Insurance
Courtesy of ChiroHealthUSA Recently, Healing Place Medical, P.C. and its owner, chiropractor Dr. Gregory Thomas White Jr., had to pay $170,000 to settle allegations of improper billing. The issue? They were accused of billing Medicare for treatments involving the...
