Time Spent Verifying & Private Insurance Plan Coverage of MNT for CKD

2021 ◽  
Vol 121 (9) ◽  
pp. A36
Author(s):  
M. Betz
Keyword(s):  
Private Insurance ◽  
Insurance Plan

scholarly journals Do Insurance-mandated Precertification Criteria and Insurance Plan Type Determine the Utilization of Bariatric Surgery Among Individuals With Private Insurance?

Medical Care ◽  
2020 ◽  
Vol 58 (11) ◽  
pp. 952-957 ◽  
Author(s):  
Hamlet Gasoyan ◽  
Rohit Soans ◽  
Jennifer K. Ibrahim ◽  
William E. Aaronson ◽  
David B. Sarwer
Keyword(s):  
Bariatric Surgery ◽  
Private Insurance ◽  
Insurance Plan

Opiate dependency among the subscribers of a New York area private insurance plan

JAMA ◽  
1993 ◽  
Vol 269 (22) ◽  
pp. 2890-2891 ◽  
Author(s):  
J. Eisenhandler
Keyword(s):  
New York ◽  
Private Insurance ◽  
Insurance Plan

A Guide to Coding and Billing for the Audiological Management of Patients Receiving Ototoxic Medical Treatments

2019 ◽  
Vol 4 (5) ◽  
pp. 936-946
Author(s):  
Dawn Konrad-Martin ◽  
Neela Swanson ◽  
Angela Garinis
Keyword(s):  
Otoacoustic Emissions ◽  
Best Practice ◽  
Private Insurance ◽  
Monitoring Program ◽  
Current Method ◽  
International Classification Of Diseases ◽  
Ethical Practice ◽  
Party Payer ◽  
High Frequency Audiometry ◽  
Icd 10

Purpose Improved medical care leading to increased survivorship among patients with cancer and infectious diseases has created a need for ototoxicity monitoring programs nationwide. The goal of this report is to promote effective and standardized coding and 3rd-party payer billing practices for the audiological management of symptomatic ototoxicity. Method The approach was to compile the relevant International Classification of Diseases, 10th Revision (ICD-10-CM) codes and Current Procedural Terminology (CPT; American Medical Association) codes and explain their use for obtaining reimbursement from Medicare, Medicaid, and private insurance. Results Each claim submitted to a payer for reimbursement of ototoxicity monitoring must include both ICD-10-CM codes to report the patient's diagnosis and CPT codes to report the services provided by the audiologist. Results address the general 3rd-party payer guidelines for ototoxicity monitoring and ICD-10-CM and CPT coding principles and provide illustrative examples. There is no “stand-alone” CPT code for high-frequency audiometry, an important test for ototoxicity monitoring. The current method of adding a –22 modifier to a standard audiometry code and then submitting a letter rationalizing why the test was done has inconsistent outcomes and is time intensive for the clinician. Similarly, some clinicians report difficulty getting reimbursed for detailed otoacoustic emissions testing in the context of ototoxicity monitoring. Conclusions Ethical practice, not reimbursement, must guide clinical practice. However, appropriate billing and coding resulting in 3rd-party reimbursement for audiology services rendered is critical for maintaining an effective ototoxicity monitoring program. Many 3rd-party payers reimburse for these services. For any CPT code, payment patterns vary widely within and across 3rd-party payers. Standardizing coding and billing practices as well as advocacy including letters from audiology national organizations may be necessary to help resolve these issues of coding and coverage in order to support best practice recommendations for ototoxicity monitoring.

Bottom Line: Who Pays the Bill for Early Intervention Services?

ASHA Leader ◽  
2013 ◽  
Vol 18 (2) ◽  
pp. 26-27
Author(s):  
Janet McCarty ◽  
Laurie Havens
Keyword(s):  
Early Intervention ◽  
Private Insurance ◽  
Infants And Toddlers ◽  
Bottom Line ◽  
Early Intervention Services ◽  
Intervention Services

Medicaid, federal education funds and private insurance all cover the costs of speech-language and hearing services for infants and toddlers. Learn who pays for what.

Enrollment Lags for Pre-Existing Insurance Plan

2011 ◽  
Vol 42 (6) ◽  
pp. 55
Author(s):  
ALICIA AULT
Keyword(s):  
Insurance Plan

Enrollment Lags for Pre-Existing Condition Insurance Plan

2011 ◽  
Vol 10 (6) ◽  
pp. 70
Author(s):  
ALICIA AULT
Keyword(s):  
Insurance Plan
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