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Insurance issues dealing with CMS to private insurance.

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Potential Denials Reported on Bills by Sole Proprietors/Practitioners
Tuesday, 15 December 2015
Some sole proprietors and some incorporated sole practitioners are reporting being denied reimbursement because they are not billing as a group (business) in field 33. Although an official explanation has not been obtained that describes what is occurring, this appears to involve the need for a second NPI number. 
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PIP Denial Based Upon ICD Code?
Tuesday, 17 November 2015
It has now been over a month since ICD-10 went into effect. Are the PIP carriers accepting ICD-10 codes? With some ambiguity in the PIP statute, most auto carriers announced they would only accept ICD-10. However, not all auto carriers announced how they interpreted the PIP statute.
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PIP ALERT ICD-9 or ICD-10?
Wednesday, 16 September 2015

As you all should know, HHS is switching to ICD-10 as of October 1, 2015.  Many of your billing software systems are set up to incorporate that change.  But, what about PIP?  Does that billing switch to ICD-10 as well?  The short answer is, who knows based upon the ambiguity in the statute, but, probably, YES.  Based upon conversations between ChiroCode and Auto Carriers, you should likely switch to billing with ICD-10.   

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PPACA Update: New FAQs replace previous document containing objectionable language
Monday, 08 June 2015

ACA Efforts Result in Federal Agency's Clarification of PPACA Language on Access to Non-MD/DO Providers

From an ACA Release of June 3, 2016, Arlington, Va. - At the urging of the American Chiropractic Association (ACA), the Centers for Medicare & Medicaid Services (CMS) has clarified a section of the Patient Protection and Affordable Care Act (PPACA) that led some states to improperly limit patient access to chiropractic physicians and other qualified non-MD/DO health care providers. 

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Reminder - PIP Class Action Settlement Funds Available from Nationwide and Titan
Tuesday, 05 May 2015

You could be owed money from Nationwide or Titan or Victoria Select Insurance Companies if you were paid less than the amount billed between January 1, 2008 and July 23, 2012 (12/31/14 for Titan and Victoria) or if you contend the Carrier(s) miscalculated the deductible on your medical charges.  Read further to learn how to submit a claim and to learn how I can recover settlement funds for you at no cost.

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