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Did Insurance Deny Your Manual Therapy Codes by Claiming It Was “Massage”?

Every medical treatment has a Current Procedural Terminology (CPT) code when evaluated and input into an insurance company’s system. CPT codes included in a customer’s policy will be approved for coverage, and excluded CPT codes will be denied. This can cause some trouble for similar therapies with similar CPT codes but greatly different treatment purposes. A common example of CPT code mix-ups is manual therapy (CPT 97140) and massage therapy (97124). Some professionals in insurance, billing, and medical industries inadvertently

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Good Letter of Protection for Florida Doctors

I have received multiple emails from doctors who want a good Letter of Protection that they can use for their office. I have spent several hours drafting this Letter of Protection and here is what you need to know: If your patient signs a Letter of Protection and the lawyer refuses to at least negotiate your bill when the case settles then call my office. We sue lawyers who refuse to pay your LOP.

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Billing Tens Units – Do I Need A License?

Many doctors have asked me if they need a special license to bill DME units like a TENS unit. The short answer is – YES, you do need a license. Most insurance companies are starting to catch on to this special license and they are denying DME (Durable Medical Equipment) CPT codes. Check your Explanation of Benefits from the different carriers. You will notice that you are not getting reimbursed by many insurance companies. See the law on needing the

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What You Need to Know About LOPs- Don’t Get Screwed

About LOPs – Lawyers and Letters of Protection- the RULE BOOK Sorry I haven’t posted any good content in a couple of weeks – I just got back from my honeymoon! Have you treated a patient under a Letter of Protection hoping to get paid when the case settles?Did the case settle and the lawyer never paid your bills? Then this blog post is for you! There are two important rules about Letters of Protections that lawyers must follow: Contract

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Ovadia Law Group – Car Accident Lawyers – Open New Office in Miami

The people of Miami can now more easily depend on Ovadia Law Group and our personal injury and car accident attorneys thanks to a brand new office location. The address of our new Miami office is 3625 NW 82nd Avenue, Suite 304, Miami, FL 33166. We wanted to find a location that is easily accessible, even during the worst rush hour traffic. After all, client convenience and satisfaction are two of the cornerstones of our principles here at Ovadia Law

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How Much is the PIP Fee Schedule Supposed to Pay?

How much does PIP pay for services? PIP allows two times the amount of Medicare Part B (aka 200%). PIP pays 80% of that amount. The link to Medicare’s fee schedule for Florida is at the bottom of this email. The PIP law made Medicare rates in 2007 as the baseline. That means that if 2013 rates are less than 2007 rates then you go with 2007 rates. Medicare rates in 2007 are typically higher than 2012-2013 rates. Also, the PIP law says

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How Long are Medical Providers Supposed to Retain Their Records?

If you ask three doctors how long they are supposed to keep medical records and copies of patient files, each will tell you a different answer. This is not necessarily a failure of those three medical providers, but instead the aftereffect of convoluted rules and regulations. In many states, including Florida, the amount of time medical records need to be retained varies depending on a medical provider’s profession and accreditation, such as MD, DO, or DC. Examples of Florida law

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The Dangers of Distracted Driving

Did you know a minimum of eight people die every day because of motor vehicle accidents involving distracted drivers? On top of that, an additional 1,161 people are injured each day, according to reports by the Centers for Disease Control and Prevention. Distracted driving is very obviously deadly, and despite the growing awareness for the danger, studies show distracted driving is on the rise. In their annual State Farm Distracted Driving Survey, the company found that the rise in distracted

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Selling TENS Units or Lumbar Supports Illegally?

Transcutaneous electrical nerve stimulation (TENS) units have become popular solutions to muscle pain. A user applies applicator pads to target areas, which are pulsed with electricity at adjusted intervals. The result is gentle and continuous muscle stimulation that can alleviate soreness without pharmaceuticals. Due to the effectiveness, safety, and generally low cost of TENS units, more and more medical providers are selling them to patients and placing them on insurance billing codes. There is a problem, though it is illegal

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Affidavit for Proof of Mailing

 Published on: Dec 7, 2015 @ 05:17 Please see the attached Proof of Mailing Affidavit. It is to be used when an insurance company claims that the bills were never received and when your office doesn’t have a certified mail card. Click here to see a nice PDF that you can download for free This form should only be completed when the insurance company claims they did not receive the bills. It should not be sent to the insurance company unless

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PIP and the 14 Day Rule

The Law: (a) Medical benefits. Eighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices and medically necessary ambulance, hospital, and nursing services if the individual receives initial services and care pursuant to subparagraph 1.within 14 days after the motor vehicle accident. My Interpretation of the Law: Even if a patient is seen by an EMT/ambulance for blood pressure/concussion then that will cover the 14 day rule. There is no rule

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Are Your Old PIP Files Worth Money?

Yes! Your PIP files are worth money! Since January 2008 the insurance companies have been paying 80% of medical bills that they capped at 200% of Medicare fee schedule. They were actually supposed to pay 80% of whatever a doctor billed. This means that you are basically owed money for every single patient if you sent a bill to PIP insurance. There are a few exceptions but 99% of the medical providers who billed PIP are owed money. For example,

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