Next Event: NCCI Edits & Modifier 59: Version 31.2
Date: June 26,2025
How Often Can I Submit Claims to an Insurance Carrier?
A question that comes up every so often is how often can I submit claims to an insurance carrier for a patient receiving outpatient therapy services. The answer actually depends on how your practice/organization is classified. In this article, I will answer the following questions:
I’m OON! What are the Pros and Cons of Submitting a Claim to the Insurer?
As a private practice owner, you have made the decision to go out-of-network (OON) with an insurer. You are now trying to identify the benefits and risks of submitting a claim to the insurer or providing the patient with a superbill. In this third article of this 3-part series, I will answer the following questions:
Institutional Outpatient Therapy Claims Being Denied
Institutional outpatient therapy providers are experiencing claims being denied by their Medicare Administrative Contractor (MAC) beginning on and after April 1, 2023 for claims received by the MAC. In this article, I will answer the following questions:
Quality Measures Available for MIPS 2019 Performance Year
The Centers for Medicare and Medicaid Services (CMS) has released the 2019 MIPS quality measures available to report by physical therapists (PT’s), occupational therapists (OT’s) and speech-language pathologists (SLP’s) that practice in the private practice setting. In this article, I will provide the measures available to PT’s, OT’s and SLP’s reporting via claims and registry. Quality Measures That Can Be Reported via Claims by Physical Therapists Quality Measures That Can Be Reported via Registry by Physical Therapists Quality Measures That Can Be Reported via Claims by Occupational Therapists Quality Measures That Can Be Reported via Registry by Occupational Therapists Quality