The No Surprise Billing Act (NSA). You might have heard of it. You might have even tried to read the thing. In my opinion, it may be the most poorly written, difficult to understand set of regulations I have encountered in my career. Much of the guidance, especially from the Chiropractic Community, is misleading, if not entirely wrong. Here is a summary of what you need to know. Does NSA Apply to Clinics? It does, in part. This is one of the more confusing areas, and many sources ...

First, what is Balance billing? When healthcare providers bill patients for charges that exceed the amount that Medicare reimburses for that service, or in other words, contractual write-offs. If the provider is participating in Medicare/ Medi-Cal balance billing, is illegal. Doctors that aren’t participating with Medicare, but they also haven’t opted out (non-participating) can balance bill you, but the total charge can’t be more than 15% than Medicare will pay. Providers that have ...

Medicare is now enforcing their protocol on secondary diagnosis codes and re-evaluation visits. Providers will need to make sure that they’re aware to schedule patients for their re-evaluations exams once they have met the diagnosis visit limit. Expect denials from Medicare if you are not following the guidelines within Short-Term, moderate, and long-term treatment codes. Please refer to the list of codes and how many visits coincide with that diagnosis to determine your

Medicare is now enforcing their protocol on secondary diagnosis codes and re-evaluation visits. Providers will need to make sure that they’re aware to schedule patients for their re-evaluations exams once they have met the diagnosis visit limit. Expect denials from Medicare if you are not following the guidelines within Short-Term, moderate, and long-term treatment codes. Please refer to the list of codes and how many visits coincide with that diagnosis to determine your