Happy 4th of July!

Happy 4th of July!

RT Welter would like to wish everyone a Happy 4th of July! With lighter restrictions this year, we hope you are once again able to spend time with your families and friends! Please remember to have a safe but also fun and relaxing holiday. To follow medical precautions, don’t forget to wear sunscreen, stay hydrated…

Modifier 25 Factsheet

RT Welter’s Modifier 25 Factsheet

Modifier 25 is a significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service. Here is RT Welter’s guide to making sense of when and how to use it. Continue reading below to learn more! The HHS Office…

UNITED HEALTHCARE WILL DENY OR LIMIT COVERAGE FOR ED COMMERCIAL CLAIMS IT CONSIDERS NON-EMERGENT

United Healthcare Will Deny or Limit Coverage For Non-Emergent ED Commercial Claims

United Healthcare has introduced a new policy that will assess ED facility commercial claims. United Healthcare will be evaluating assessments based on several factors involving the patient’s problem, the intensity of the service, and the patient complicating factors and external causes.  Read more about it below: The new policy will apply to “commercial fully insured…

Post-Payment Reviews Return

Post-Payment Reviews Return

Post-payment reviews have returned. Nationally, Medicare Administrative Contractors (MACs) have restarted post-payment reviews following their suspension due to COVID-19. In their weekly MLN Connects newsletter dated August 6, 2020, the Centers for Medicare and Medicaid Services (CMS) wrote, “Beginning August 17, the MACs are resuming with post-payment reviews of items/services provided before March 1, 2020.…