Problems Affecting Easy Billing

by | Jul 16, 2019

Several changes over the past few years have made the act of collecting what was once considered “easy billing” significantly more challenging:

  • AB72 rules
  • GI reimbursement policies
  • Surge of Medi-Cal members into PPO plans and HMO relationships
  • Enrollment requirements for providers seeking reimbursement for Medi-Cal PPO/HMO services
  • Freeze on preferred rates
  • Extensive provider enrollment timelines with major payers
  • Drastically shortened timely filing limits, which we expect to occur with other major payers within the near future

Let’s work together to combat these changes and protect your practice from non-payment of services.

  • Brush up on GI reimbursement policies
  • Respond timely to requests for information and documentation – these requests will come from coding, billing, provider enrollment, etc.
  • Know and adhere to your timely filing limits, – submit your cases in a manner that allows sufficient processing time