Monday, March 19, 2018
Reimbursement Downloads



Covered California

CMA published Tips and Tools for physicians and staff:

Surviving Covered California - Part 1

Surviving Covered California - Part 2

Surviving Covered California - Part 3

Surviving Covered California - Part 4

HIPAA Security Rule - Working from home and being secure.

PrivaPlan Remote Home Use

New Vs. Established Patient Scenarios


Global Surgery Fact Sheet

GloballSurgery Aug 2013

Top Five Tips to Successful Appeals

 Tips for Successful Appeals


Frequently Asked Questions from the March 28, 2012 Medicare Preventive Services National Provider Call: The Initial Preventive Physical Exam (IPPE) and the Annual Wellness Visit (AWV).

The ABC's of the annual wellness visit
The ABC's of the IPPE

Medicare Audit Guide for Physicians


Making Changes to a Medical Record

Corrections vs. Alterations

Claim Correction Form

A one-page form that can help make the process of filing corrected claims more efficient~Physicians may adapt for use in their own practices.
Claim Correction Form.doc


Physician treating family member

From the Medicare Carrier Manual, Guidelines on physician's treating family members 

Medicare EM Article

This E/M article shares helpful hints when submitting services to J1 Part B for processing.

CMS Signature Requirements

For medical review purposes, Medicare requires that services provided/ordered be authenticated by the author. The method used shall be a hand written or an electronic signature. Stamp signatures are not acceptable.... 



Medicare Consultation Code Crosswalk

(DEC2009) This chart includes a list of CMS web pages that ALL Medicare providers use most frequently.

Modifier AI Decision Chart
Use this decision chart to determine whether you should bill with modifier AI.

Selecting a Practice Mgmt System

The upcoming transition to the government's modified electronic transaction standards, coupled with the Medicare and Medicaid electronic health record incentive program, will require physician practices to upgrade or replace their current practice management software.

To help you select and purchase the most appropriate software for your practice, the American Medical Association (AMA) and the Medical Group Management Association (MGMA) collaborated to develop a new online toolkit. The new "Selecting a Practice Management System" toolkit provides a roadmap to make this process easier for your practice. You can use this information to establish your practice needs and take advantage of recent improvements in automation.

Since many private insurance carriers are still accepting consultation codes, The AMA clarified consultation services and transfer of care.

Copyright 2018 by Santa Clara County Medical Association