Stories written by Alisa Pierce

The Waco Way: How This Addiction Medicine Specialist Targets Primary Care Challenges - 05/09/2024

How one addiction medicine specialist turned passion into practicality to target behavioral health challenges in primary care.

ChatGPT Adviser Harvey Castro, MD, Shares AI Insights at TexMed - 05/09/2024

As a Dallas emergency physician, Harvey Castro, MD, began experimenting with ChatGPT – an artificial intelligence chatbot trained on data from the internet to generate human-like responses to text prompts – in November 2022 after asking himself what he’d “want from AI in a hospital setting.”

Virtual Vigilance: Robust Cybersecurity Can Safeguard Practices - 05/09/2024

System blackouts. Ransom notes. Lost revenue. Compromised patient care. Once straight from physicians’ nightmares, these threats are now reality for their practices as cyberattacks infiltrate health care. The more medical practices and health care organizations fall victim to ransomware cyberattacks, the more important it becomes to prevent them.

The Secret Handshake: TMA Experts Identify Medical Documentation Missteps - 05/06/2024

TMA experts help identify medical documentation missteps that may lead to payment and prior authorization denials.

Coding with Care: Knowing Billing Codes for Complex Care Can Maximize Revenue, Access to Care - 05/06/2024

Knowing billing codes for complex care can maximize revenue and access to care.

Valuable Screentime: Telemedicine Paves the Way for Increased Access - 05/06/2024

Telemedicine paves the way for increased health care access.

Superior, Availity Reconnected to Change Healthcare Clearinghouse - 04/26/2024

Claims are now automatically flowing to Texas managed care organization Superior HealthPlan through Availity after the platform reconnected to Change Healthcare’s rebuilt clearinghouse April 8.

Cigna to Deny Claims Without Z-Code Documentation - 04/24/2024

Starting July 14, Cigna Healthcare will deny certain claims that are billed with a Z code and without documentation, a move that could add to physicians’ administrative burden.

Novitas Solutions Warns of Top 10 Medicare Claims Errors - 04/15/2024

Novitas Solutions, the Medicare administrative contractor for Texas, has released a top 10 list of errors made between January and March 2024 physicians should be aware of to mitigate billing problems in their practices.

Cigna Launches Digital Newsroom for Payer Updates - 04/12/2024

Physicians and practice staff looking for updates from one of Texas’ major payers, Cigna Healthcare, can now refer to the company’s new digital newsroom.

Shielding the Gold Card Law: TMA Fights to Guarantee Gold Card is Implemented as Intended - 04/09/2024

Texans earned one of its most prolific victories with its prior auth exemption law but still fights to guarantee it's implemented as intended.

Medicare May Seek Payment Recoupment for 2023 Claims - 04/09/2024

A new report by the Government Accountability Office shows physicians may face possible recoupments – or additional payment – for claims filed in 2023 as a result of over and underpayments by Medicare, Medicaid, and other federal programs.

Postpartum Coverage Extension Brings Payment Complexities - 04/05/2024

As the 12-month postpartum coverage Texas legislature approved took effect March 1, physicians and their practice staff should take note of subsequent payment complexities, Texas Medical Association experts caution.

Speaking Their Language: TMA Experts Fight for Physicians’ Best Interests - 04/01/2024

Texas Medical Association experts communicate with payers on behalf of physicians’ best interests.

Still Beating: Rick Snyder, MD, “Won't Stop Knocking on Legislators' Doors” - 04/01/2024

Despite the end of his term, outgoing TMA President Rick Snyder, MD, “won't stop knocking on legislators' doors anytime soon.”

Aetna Set to Pay Medicare Advantage G2211 Claims - 03/27/2024

The list of health plans providing payment for Medicare’s new add-on “G” code continues to grow with Aetna as the latest insurer to cover G2211 for Medicare Advantage claims Aetna confirmed with Texas Medical Association coding experts that its Medicare Advantage claims platform was updated in March to allow payment for the code, used to document the coordination of care for patients with complex or serious conditions. For now, the plan’s policy is only accessible through a physician’s Aetna portal.

HHS Removes Home Address Telemedicine Requirement After TMA’s Urging - 03/18/2024

The U.S. Department of Health & Human Services will allow for the submission of a post office box or personal mailbox, offered by a private delivery service as a practice location address, when a physician does not have a physical location other than their home address, heeding the Texas Medical Association’s call.

UPDATE: Cyberattack Disrupts Payment and Revenue Cycle Management - 03/12/2024

Physicians using Change Healthcare – a health care technology company that is part of Optum and owned by UnitedHealth Group – may experience claims disruptions after the company experienced a cyberattack on Feb. 21.

CMS Announces Flexibilities Following Cyberattack - 03/12/2024

The Centers for Medicare & Medicaid Services announced several flexibilities that aim to help physicians in the wake of the cyberattack against Change Healthcare, which upset payment and revenue cycle management operations in pharmacies and health systems across the country.

Physicians May Face Lower Payment as CMS Resumes Lab Data Collection - 03/11/2024

The Centers for Medicare & Medicaid Services will continue to collect data from physician-owned laboratories to inform private payer rates despite pushback from the Texas Medical Association.

TMA Develops New AI Education - 03/10/2024

Responding to significant interest from members after a 2023 standing-room-only TexMed event, the Texas Medical Association has developed a free webinar for members to learn how to integrate augmented or artificial intelligence technology, including ChatGPT, into patient care.

Party With a Purpose - 03/05/2024

The Texas Medical Association Foundation’s (TMAF’s) 31st annual gala, Wonderland, will feature designs and décor inspired by Lewis Carroll’s classic story Alice’s Adventures in Wonderland.

Telemedicine Flexibilities Preserved in Medicare Fee Schedule - 03/05/2024

The 2024 Medicare physician fee schedule (MPFS) extended several pandemic-era telehealth flexibilities, many of which impact physicians who treat rural patients and those with behavioral health needs.

Coding Changes in Fee Schedule Promote More Accurate Payment for Complex Visits - 03/05/2024

The 2024 Medicare physician fee schedule allows physicians to list G2211 in addition to codes used in office or outpatient visits for new or established patients (i.e., 99202-99215). Physicians also can use it for telehealth visits.

Novitas Makes Mass Payment Adjustment for Telehealth Claims - 02/27/2024

Thanks to the vigilance of the Texas Medical Association’s payment specialists, Medicare administrative contractor Novitas Solutions updated its system to ensure all claims billed with place of service (POS) code 10 will be paid correctly.