Practice Management and Prior Authorization for Interventional Pain and Orthopedic Spine Surgery. Patients Access and Healthcare Financial Management Consulting Company | GoHealthcare Practice Solutions
  • About
  • Services
    • Prior Authorization Services
    • Patient Access Services
    • Medical Scribe Services
    • Coding and Documentation Audit Review
    • ​E/M & Surgical Coding Education and Training
    • RCM FULL SERVICES
  • READ OUR BLOG
  • Let's Meet in Person
    • 2023 ORTHOPEDIC VALUE BASED CARE CONFERENCE
    • 2023 AAOS Annual Meeting of the American Academy of Orthopaedic Surgeons
    • 2023 ASIPP 25th Annual Meeting of the American Society of Interventional Pain Management
    • 2023 Becker's 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference
    • 2023 FSIPP Annual Conference by FSIPP FSPMR Florida Society Of Interventional Pain Physicians
    • 2023 New York and New Jersey Pain Medicine Symposium
  • Testimonials
  • Frequently Asked Questions and Answers - GoHealthcare Practice Solutions
  • FREE ASSESSMENT
  • Readers Questions

Blog Posts

How to Get Paid for Obesity Services

5/10/2017

0 Comments

 

According to the Centers for Disease Control and Prevention
“Obesity, a common and costly health issue, affects more than one-third of adults and 17 percent of youth in the United States. “
By the numbers, 78 million adults and 12 million children are obese—figures many regard as an epidemic.

​Being obese increases the risk for heart disease, stroke and type 2 diabetes—the first, fourth and seventh leading causes of death, respectively—and contributes to more than one in five cancer-related deaths. Obesity-related health care spending continues to grow, with researchers estimating medical costs at $147 billion annually, including $7 billion for Medicare prescription drugs.


The American Medical Association recognized obesity as a disease in 2013 and the American Academy of Pediatrics recommended obesity prevention, assessment and patient counseling in 2007.

Medicare first recognized obesity as a medical condition in 2004 and began covering interventions when scientific evidence demonstrated their effectiveness.
In 2011, Medicare issued a Coverage Decision memorandum outlining requirements for intensive behavioral counseling and therapy for beneficiaries affected by obesity.

As of January 2012, Medicare and most private insurers cover obesity screening and behavioral counseling. In addition, as of Jan.1, 2014, the ACA requires: No consumer cost- sharing. Most insurance plans in all 50 states are required to cover certain services with no cost-sharing, including obesity screening and counseling for all adults and children. This includes no annual deductible amount, no enrollee copayments or coinsurance. Premium surcharges for being obese are prohibited in most insurance policies in all 50 states, including those sold through exchanges.
Source: http://www.ncsl.org/research/health/aca-and-health-mandates-for-obesity.aspx
​


Medicare Guideline and Policy:
Make sure that …

  • Your specialty is eligible for Obesity Services (Prevention, Treatment, Counseling and/or Coordination of Care)
  • Your specialty is properly listed with your contracted payers
  • You have to do your patient’s insurance verification for benefits and eligibility – specifically for Obesity Services.

Eligible Specialties:
  • General Practice
  • Family Practice
  • Internal Medicine
  • Obstetrics/Gynecology
  • Pediatric Medicine
  • Geriatric Medicine
  • Nurse Practitioner
  • Certified Clinical Nurse Specialist
  • Physician Assistant

Geriatric Medicine
Nurse Practitioner
Certified Clinical Nurse Specialist
Physician Assistant
0 Comments

Your comment will be posted after it is approved.


Leave a Reply.

    Picture
    ABOUT THE AUTHOR:
    Ms. Pinky Maniri-Pescasio is the Founder of GoHealthcare Consulting. She is a National Speaker on Practice Reimbursement and a Physician Advocate. She has served the Medical Practice Industry for more than 25 years as a Professional Medical Practice Consultant.

    View my Profile on Linkedin
    View my profile on LinkedIn
    READERS QUESTIONS
    Picture
    Ad: Immune Shield is the breakthrough new, doctor-approved supplement for quickly strengthening and protecting your immune system. Check it out!
    Picture
    Ad: Make Dinner in 15 Minutes

    search here

    Medical Billing and Coding Webinars
    Learn from the EXPERTS in the Industry

    RSS Feed

    Archives

    March 2023
    February 2023
    January 2023
    November 2022
    September 2022
    July 2022
    June 2022
    May 2022
    April 2022
    March 2022
    February 2022
    October 2021
    July 2021
    June 2021
    February 2021
    January 2021
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    April 2020
    March 2020
    December 2019
    February 2019
    September 2018
    August 2018
    February 2018
    January 2018
    December 2017
    September 2017
    August 2017
    June 2017
    May 2017
    February 2017
    October 2016


    Categories

    All
    10 Common Reasons Claims Gets Denied And Reject
    2019 New CPT Codes Medicare Payments For Virtual Services Remote Monitoring Interprofessional Consultation
    Chronic Care Management In 2017 Changes
    Events
    Medical Modifiers
    Pain Management Billing
    Pain Management Billing Codes
    Practice Management
    READER'S QUESTION
    Revenue Cycle
    Spinal Fusion Billing And Coding
    When To Use Medicare's ABN Advanced Beneficiary Notice Claim Reporting Modifiers
    You Be The Biller
    Your Be The Coder

    RSS Feed


    BROWSE HERE

    All
    10 Common Reasons Claims Gets Denied And Reject
    2019 New CPT Codes Medicare Payments For Virtual Services Remote Monitoring Interprofessional Consultation
    Chronic Care Management In 2017 Changes
    Events
    Medical Modifiers
    Pain Management Billing
    Pain Management Billing Codes
    Practice Management
    READER'S QUESTION
    Revenue Cycle
    Spinal Fusion Billing And Coding
    When To Use Medicare's ABN Advanced Beneficiary Notice Claim Reporting Modifiers
    You Be The Biller
    Your Be The Coder


© COPYRIGHT 2019 GoHealthcare Consulting and Business Development LLC. ALL RIGHTS RESERVED.
  • About
  • Services
    • Prior Authorization Services
    • Patient Access Services
    • Medical Scribe Services
    • Coding and Documentation Audit Review
    • ​E/M & Surgical Coding Education and Training
    • RCM FULL SERVICES
  • READ OUR BLOG
  • Let's Meet in Person
    • 2023 ORTHOPEDIC VALUE BASED CARE CONFERENCE
    • 2023 AAOS Annual Meeting of the American Academy of Orthopaedic Surgeons
    • 2023 ASIPP 25th Annual Meeting of the American Society of Interventional Pain Management
    • 2023 Becker's 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference
    • 2023 FSIPP Annual Conference by FSIPP FSPMR Florida Society Of Interventional Pain Physicians
    • 2023 New York and New Jersey Pain Medicine Symposium
  • Testimonials
  • Frequently Asked Questions and Answers - GoHealthcare Practice Solutions
  • FREE ASSESSMENT
  • Readers Questions