Specializing in Out-of-Network Medical Billing
Audit & Analysis of Existing Systems and Policies
Full Billing Service for Patient & Insurance Accounts
Fee Schedule/Rates Analysis
Analysis of Coding
VGA Billing and their sister company, Creative Practice Solutions (CPS), regularly provide professional content for various industry resources:
Paul von Gahl
Elizabeth Apicella, CPC, CENTC, COSC, CPMA
If your Out-of-Network biller cannot answer these questions, you may be losing revenue.
What are multiple procedure reductions and when is it okay for carriers to apply them?
What is MNRP, MRC1 and MRC2?
What are third party pricing companies?
When, if ever, is it okay to negotiate rates for out-of-network claims?
Can the same surgery performed by the same non-par Doctor on two different patients with the same insurance policy have two completely different allowed amounts? If yes, how?
Which carriers send checks to the patients regardless of whether the provider accepts assignment?
What is catastrophic coverage?
Can an E&M code be billed within the global period? If yes, how?
Can a surgical procedure be billed within the global period? If yes, how?
What are the three components of an E&M code that must be documented?
If two surgical codes are legitimately mutually exclusive, which one is supposed to get paid?