I am an attorney in florida handling personal injury protection (pip) issues. Pip insurers utilize medicare fee schedules, coding and payment methodologies. I would like to discuss a particular coding methodology called multiple procedure payment reduction (mppr). Specifically i would need someone who understand mppr and can look at an explanation of benefits and determine whether an insurance company is properly reimbursing the doctor.+19 Other Responses
Center For Medicare And Medicaid Services
We are looking to speak with 2-3 experts to understand the decision-making processes for cms (centers for medicare and medicaid services) reimbursement, specifically for new prescription medications to treat cough.
This would be for a 1-hour phone consultation. Please respond as to your relevance in this space and provide a few brief statements to the questions below:
1. Are you familiar with or cms (centers for medicare and medicaid services) rules at the national level?
2. Do you currently work for cms or serve on a working group?
3. Can you describe your experience with managed medicare lives?+30 Other Responses
Medical Billing And Reimbursement
This full-time job post has been authorized by zintro.
Job position: director, billing & reimbursement
provides effective leadership and management of the reimbursement department in revenue management, medical insurance authorizations and managed care contracting.
Essential duties and responsibilities:
• develops, implements and manages the policy and procedures to ensure complete, accurate, and compliant processes that result in optimal collections and customer service performance for the organization.
• directs the complete revenue cycle process for reimbursement services: ensures timely authorization of tests; initiates prompt calls and manages and monitors contract status and compliance.
• is the key interface with xifin, our billing and collection service to ensure pricing is accurate and billing policies are followed.
• coaches, trains and mentors team to meet departmental goals.
• establishes performance metrics and reporting on progress to management on a weekly basis.
• identifies issues and opportunities within the reimbursement process and implements strategies to improve efficiency and effectiveness.
Knowledge, skills and abilities:
• third-party reimbursement, managed care organizations guidelines, medicaid & medicare regulation experience required, medical terminology experience preferred.
• ability to read, analyze and interpret documents, periodicals, professional journals, technical procedures and government regulations.
• strong financial, problem solving, and organizational skills.
• ability to read, interprets, and analyzes business and accounting documents.
• effective communication skills, the ability to provide clear and concise oral/ written information to internal/external customers.
• ability to maintain confidentiality and hipaa compliance practices.
• bs degree in business or a related field
• 8 years revenue cycle experience and 5 years in a leadership
role overseeing medical authorizations, managed care and reimbursement employees.
Candidate must be authorized to work in the u.S.A.+11 Other Responses
Medicare Provider Enrollment
We were initially set up incorrectly with medicare as an idtf, and medicare was denying all e/m codes. We re-sent the application with the change to a "group practice" so that we can bill e/m codes as well as x-ray codes. However, medicare is telling us that we may have to wait another 90 days for that to go through. We can't wait that long, we are a new start-up with limited resources....we need help with medicare.+4 Other Responses