Anthem's SURG.00017 policy, prohibiting use of the CyberKnife for prostate cancer, is wrong.

Assignment forms you must have your patients sign – Why you must have your patients sign an ERISA assignment form.

How to Win Payment for Radiation Oncology Claims Denied by Medicare & How to Use Pre-Hearing Briefs at the ALJ Level of Appeal

Assignment forms you must have your patients sign – Why you must have your patients sign an ERISA assignment form.

What Every Doctor Billing for Services Should Know: Tips For More Effective Billing – Make sure you are doing all you can to protect yourself from billing inquiries while maximizing your billing practices!

Fighting Payor Abuse in California – When it comes to "deselection" by insurance companies, doctors who protest denied claims are safer than those who remain silent in the face of nonpayment for services.

Just Say No to Insurance Company Requests for Overpayments (Part 1) – What to do when insurance companies send you a request for repayment of an overpayment.

Just Say No to Insurance Company Requests for Overpayments (Part 2) – Includes a more expansive letter you can use in any part of the country to protest requests for repayments of overpayment.

Assistant Surgeon Fees for Bunionectomies – Almost all bunionectomy procedures should allow for an assistant surgeon.

Note: All articles are in online HTML versions and in Adobe Acrobat PDF format (PDF version at the bottom of each article).

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How to Win Medicare Appeals (website)

How to Win Medicare Appeals (purchase)

• The American Bar Association just published my book, "How to Win Medicare Appeals". It is available in both print and digital format here, and is based on 20 years of experience representing a wide cross section of providers needing help at Medicare's third level of appeal with the Administrative Law Judges. The book is written in a short question, short answer format and explains how to solve the problems that inevitably arise during Medicare appeals. One small step at a time, the book walks the reader through the entire appeals process, from the redetermination appeal through the ALJ appeal, solving the common problems encountered in the chronological order of their appearance.
  
  As of May 24, 2020.
  
  
• How to appeal and win radiation oncology claims that have been denied for payment by Medicare
  
  As of January 1, 2012.
  
  
• Appealing denials of CPT code 69990, surgical microscope add-on code for ENT surgeons
  
  
• Appealing denials of CPT codes 95920 and 95867, single nerve monitoring done by the surgeon during ENT procedures (when the facial nerve alone is at risk)
  
  
• Appealing denials of diagnostic ultrasound procedures (CPT codes 76880 and 76942) performed in-office by doctors other than radiologists
  
  
• Appealing denials of payment for high energy Extra Corporeal Shock Wave procedures (temporary CPT code 2825X) performed by podiatrists and orthopedists
  
  As of August 19, 2005.