News Updates

CMS-1500 Claim Form Step-by-Step Instructions

Dental carriers now require that any service that COULD be payable by any medical carrier, including Medicare; be submitted to the medical insurance first. Dental offices who have NEVER had to consider billing medical insurance are faced with the prospect of either being able to bill medical (correctly) or telling their patients that they will not assist them in getting the benefits, and possibly care, they deserve.

The Promoting Integrity in Medicare Act (PIMA) or HR 2143, has been introduced to Congress that seeks to update Medicare policies by preventing self-referrals related to advanced imaging services, radiation therapy, anatomic pathology and physical therapy.

The new legislation has been designed to have a direct impact on the services provided by physicians who self-refer for the performance of certain designated health services. If passed, PIMA would provide for increased penalties for Stark law violations involving the specified non-ancillary services.

The FBI and Department of Justice officials today announced the disruption of one of the largest Medicare fraud schemes in U.S. history. An international fraud ring allegedly bilked Medicare out of more than $1 billion by billing it for unnecessary medical equipment—mainly back, shoulder, wrist, and knee braces. 

Health IT giant Verona, Wis.-based Epic Systems has been hitwith a False Claims Act lawsuit that alleges the company's softwaredouble-bills Medicare and Medicaid for anesthesia services, resulting in thegovernment being overbilled by hundreds of millions of dollars.