Medical offices bill insurance providers for clients' services. Learn what's involved, including HIPAA regulations, what to include and what can go wrong.

Balance billing refers to a bill you may receive for medical costs that remain after you've paid what the insurance said you should and your insurance has paid its share. A balance bill may be a ...

In Aetna Health Inc. v. Davila, the U.S. Supreme Court set forth a two-prong test to determine whether federal jurisdiction exists over a plaintiff’s claims. The CMS-1500 Health Insurance Claim Form ...

CMS has updated its 1500 Claim Form to prepare for the ICD-10 code set. The new CMS-1500 form version 02/12 will replace the version 08/05 and give providers the choice of using ICD-9 or 10 diagnosis ...

This past Tuesday, the National Uniform Claim Committee, or (NUCC), released an approved transition timeline for the new CMS 1500 form on their website. Recently, the NUCC announced the approval of ...

Is the patient covered by Medicare? Patients must have current coverage for Medicare to reimburse CNSs or other providers. If a patient is enrolled in a Medicare + Choice program (managed care), the ...