Diligent Medical Billing

29/06/2023

We will be closed for the 4th of July. Wishing everyone a very Happy and Safe Celebration!

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22/05/2023

Closed on Memorial Day

We wish you all a happy 3 day weekend!

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21/03/2023

Our latest news

With the end of the PHE, for many of our clients this will create some large shifts, for some, none at all!

For our providers who offer Telehealth, the changes could be drastic. But it is largely unknown how big of a shift this will be. We do know that at least some of the policy expansions will roll back. I personally doubt things will go entirely back to the way they were pre-Covid. I do believe we will continue to have some expanded benefits. What we have in black and white is information from Medicare.

This is a nicely laid out quick reference fact sheet:
https://www.cchpca.org/2023/03/MEDICARE-TELEHEALTH-POLICIES-POST-PHE-AT-A-GLANCE-FINAL-MAR-2023.pdf

I do believe many carriers will go back to requiring patients to use services such as Doctor On Demand, Teledoc, and the likes. I do believe more and more the commercial carriers will require that care be established in person, maybe require in person visits after a certain period of time, etc. We'll continue to ask these questions as we check benefits and of course keep all affected providers apprised of changes and trends we are seeing.

Stay tuned and be sure to give those carrier email updates a good look as you receive them. If you think of it while you're reading them, please feel free to forward them to us with any questions and we'll learn the answers together.

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27/01/2023

Our latest news

Secure Emails and Preparing for Telehealth Changes

Secure, HIPAA Compliant, Email. Patients more and more prefer, possibly only respond to, electronic communication. Openly conversing with patients via regular email is not secure and is not HIPAA compliant. Even paid services like Google Workspace, where you have a signed BAA, is not HIPAA compliant. It's only secure if you are communicating within your organization. For example, I do use Google Workspace. Any of my staff that has .com can communicate with others .com securely. But once those emails go to anyone who is not part of my organization, the emails are no longer secure. The key term to realize, look for and understand is "End to End Encryption". I'm sure we've all seen secure emails, usually your insurance contracts will come via secure email. It's the emails that you have to create and use a password to open. There are lot's of choices for secure email. We use Hushmail. Another I see often is Proton. As long as it's end to end encryption and the service will sign a BAA for you, that's the one to choose! Many of the EMRs our clients use have secure messaging built in. If you have one of those EMRs, be sure you are using it 100% of the time. Even if a patient initiates the conversation via regular email, you should move the conversation, your reply, to a secure email.

Telehealth Changes Are Coming! All of the expanded coverage, relaxed requirements, will be coming to an end. In 2024, for example, Medicare will no longer allow Telehealth when the patient is at home. The expansions allowing PT, OT and ST via telehealth will be coming to an end. The stricter requirements for services providers are using to provide telehealth will come back into play. Most of the time for services that are routinely covered for telehealth, will require some in person visits. One carrier recently sent notification that the provider cannot establish care via Telehealth, the first visit must be in person starting in April. I'm of the opinion that telehealth is NOT going away. It will still be widely used, accepted, reimbursed. The rules however will become more strict as we get closer to the end of the PHE.

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17/12/2022

Happy Holidays!

Our whole team at Diligent Medical Billing wish you the happiest of holidays and best wishes for the new year!

With the coming of the New Year, always a great idea to remember to ask all returning patient's and clients about possible changes to their insurance plans for 2023. The sooner we know the better!

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16/11/2022

Thanksgiving Holiday

Like Many of you, our team will be taking time Next Thursday and Friday, 11/24 and 11/25, to spend time with friends and family. We all wish you a very happy Thanksgiving.

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21/09/2022

Urgent Notification

First Choice Health issued this bulletin referencing the No Surprise Act (NSA). You will be required to re-attest via Provider Source and CAQH every 90 days or you'll be removed. The bulletin is dated 3/23/2022, however I just received it at 1:30 am this morning, 9/21/2022.

Please urgently review the bulletin herehttps://www.fchn.com/documents/ppo/providers/ppoprovidercontractedproviders/20220324-prb-032201providerchangesnsa.pdf

03/04/2022

Our latest news

For our Washington Providers: Did you see Regence's February Newsletter? "The Connection"? Buried on page 12 are BIG changes to Pre-Authorization Requirements: "Pre-authorization

requirements to end for
chiropractic, acupuncture
and massage services
Pre-authorization will no longer be required for most
chiropractic, acupuncture and massage services
delivered April 1, 2022, or later. Currently, providers
submit pre-authorization requests for these services
to eviCore.
Pre-authorization will still be required for:
- Services occurring through March 31, 2022
- Services provided to members of administrative
services only (A*O) groups that have purchased our
Physical Medicine program with the chiropractic/
acupuncture/massage (CAM) component
Use Availity Essentials, availity.com, to check whether
services require pre-authorization.

Here's the newsletter: beonbrand.getbynder.com/m/21763ef5397cba2b/original/The-Connection-February-2022.pdf

And they continued with: "Changes to UMP

pre-authorization
As of January 1, 2022, physical therapy (PT),
occupational therapy (OT) and speech therapy (ST)
services for Uniform Medical Plan (UMP) members no
longer require pre-authorization.
Our Appeals team has been reaching out to providers
who received denials from eviCore for services
provided in January to confirm that these denials will
be overturned.
This change includes both School Employees Benefits
Board (SEBB) and Public Employees Benefits Board
(PEBB) members.
Services are subject to members’ benefits, which
should be confirmed through Availity Essentials:
availity.com.
Reminder about spine, pain and joint
pre-authorization
Regence began reviewing pre-authorization requests
for spine, pain and joint services rendered to UMP
members on January 1, 2022. eviCore previously
reviewed these requests.
Additionally, spinal injections for UMP members are
subject to Health Technology Clinical Committee
(HTCC) policy and require a provider attestation."

Keep in mind that this does not mean they won't replace and renew the pre-authorization requirements. As always we'll keep watching for changes and trends.

Telehealth: At the beginning of the pandemic and up until recently, a lot of the rules were lightened. But as we continue to widely use Telehealth as a service delivery method for our patients, it's very important to remember HIPAA. Be sure that you're using a HIPAA compliant, secure platform. Many EMR's have a platform embedded. These you can feel confident about. If you're using Zoom or something similar, be sure that it's HIPAA compliant. You can read more here. hipaajournal.com/hipaa-guidelines-on-telemedicine (https://www.hipaajournal.com/hipaa-guidelines-on-telemedicine/)

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15/12/2021

Our latest news

Getting Ready for 2022!

I don’t know about you, but time sure is flying for me! I can’t believe it’s already the end of the year!
As we’re thinking ahead to January, just a few reminders to help us all prepare for a prosperous new year!

Things To Consider

Benefit Verifications: The DMB team will be working Diligently 😉 to get these benefits verified and uploaded for you as quickly as possible. We’re already looking ahead at your schedules and prepping as much as we can so we can hit the ground running. Here’s what you can do to help:
a. Please be sure to always ask everyone at their first appointment of the year if they’ve had any insurance changes. If they do have new insurance please let us know ASAP
b. Bring your patience! We will be met with very long hold times and a large influx of requests. We will get the benefits to you as quickly as possible. It’s very important to us as well!
hem. Something personal and relevant to your business is always good.

Collecting Deductibles at the time of Service:

We’ll work hard to get this information to you in a timely manner. When you do know that a patient does have a deductible to meet, collect it at the time of service. This is so much more effective than chasing the money later.

Keep an eye on your fee schedules. These may change. We’ll also work hard to update you to changes in fee schedules. If you do get something from the carriers in regards to your fee schedule, please share that with us

Check up on your systems:

a. Is your EMR working effectively for you?
b. Are patients able to easily pay online?
c. Is your website up to date?
d. Did you know you can avoid transaction fees when paying DMB? We do accept Cash App: $KarenSalmon. You are also welcome to mail a check. Over the course of a year this can add up to a lot of savings 😊

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19/11/2021

Providers need to be sure to read up on and develop a plan for the Surprise Billing Act going into effect 1/1/2022! Read more about it from CMS here https://www.cms.gov/newsroom/fact-sheets/requirements-related-surprise-billing-part-ii-interim-final-rule-comment-period

On September 30, 2021, the Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury (collectively, the Departments), along with the Office of Personnel Management (OPM), released an interim final rule with comment period, entitled “Requirements Rel...