KR2 Medical Billing

KR2 Medical Billing Owned by a Certfied Professional Biller (through AAPC). Conveniently located in Hastings on Hudson, NY.

I currently offer only online medical and billing coding training. Please visit my website kr2billing.com for more information.

05/25/2026

Healthfirst Genertic testing- updated reimbursement policies

Did you know that Healthfirst has partnered with an outside company-Concert Genetics- to update their reimbursement policies for both molecular and genetic testing? If you are a NY provider and accepting Healthfirst members then this blog post is for you! For any DOS on May 1,2026 and there after the Healthfist will aligb with the policies that are represented in the Concert Genetic Portal....

Did you know that Healthfirst has partnered with an outside company-Concert Genetics- to update their reimbursement policies for both molecular and genetic testing? If you are a NY provider and acc…

UHC MO community provider appt availabilityIf you are a provider located in Missouri and accepts UHC Community Health me...
05/03/2026

UHC MO community provider appt availability

If you are a provider located in Missouri and accepts UHC Community Health members then make sure your office is compliant and adheres to the following appointment availability standards. Allowable patient wait times (in office)- 1 hour from the scheduled appt time. Providers also have to have after hour coverage- acceptable are the following: Answering service-comnects the member directly with provider, contacts the provider and then provider returns the call, or provides the member with the direct phone number to the provider/covering…...

If you are a provider located in Missouri and accepts UHC Community Health members then make sure your office is compliant and adheres to the following appointment availability standards. Allowable…

Healthfirst Lab Prior auth updated listIf you are a labolatory that accepts Healthfirst members, then this blog post is ...
05/02/2026

Healthfirst Lab Prior auth updated list

If you are a labolatory that accepts Healthfirst members, then this blog post is for you! For any DOS 4/1/26 and thereafter the following codes will require a prior auth: Image via Healthfirst website Find this type of content useful? Follow my blog for more!

If you are a labolatory that accepts Healthfirst members, then this blog post is for you! For any DOS 4/1/26 and thereafter the following codes will require a prior auth: Image via Healthfirst webs…

05/01/2026

Aetna: Pre-auth requirenments changes

The following changes/updates apply to Medicare and Commercial plan types only. Medicare and Medicaid DME: for any DOS beginning 7/1/25 and thereafter the following codes will no longer require prior auth: E1230- electric scooters Medicare and Commercial Dental pre-auth changes: the following codes will no longer require an auth- Orthognatic surgery (codes: D7944, D7945, D7946, D7947, D7948, D7949, D7950, D7955, D7995, D7996)...

The following changes/updates apply to Medicare and Commercial plan types only. Medicare and Medicaid DME: for any DOS beginning 7/1/25 and thereafter the following codes will no longer require pri…

04/29/2026

Fideliscare: E/M reimbursement policy

If you are NY provider that accepts Fideliscare members then this blog post is for you! E/M modifiers: Modifier 25 should be applied to E/M code If the member receives a same day procedure in addition to the E/M code please use the modifier 25 If the patient receives a preventative service on the same day as E/M - please append modifier 25 on E/M code…...

If you are NY provider that accepts Fideliscare members then this blog post is for you! E/M modifiers: Modifier 25 should be applied to E/M code If the member receives a same day procedure in addit…

04/28/2026

Oscar Health: member appeals info

Are you a member who has Oscar Health or a NY provider that accepts Oscar Health members? Then this blog post is for you! Please do not submit the member appeals to the NY office address!!! Appeals Mail Address: Oscar Health P.O.Box 52146 Phoenix, AZ 85072-2146 Phone: 1-855-672-2755 Fax: 1-888-977-2062 Email: [email protected] Online: Member portal or hioscar.com/forms Find this information useful? Follow my blog for more!

http://kr2billing.com/2026/04/28/oscar-health-member-appeals-info/

Are you a member who has Oscar Health or a NY provider that accepts Oscar Health members? Then this blog post is for you! Please do not submit the member appeals to the NY office address!!! Appeals…

Aetna Betterhealth NJ: Mental Health PHP and transportationAre you a community mental health center that provides PHP se...
04/27/2026

Aetna Betterhealth NJ: Mental Health PHP and transportation

Are you a community mental health center that provides PHP services and transportation? Then this blog post is for you! Proper Coding: H0035-Mental Health Partial Hospitalization (PHP) treatment, less than 24 hours, billed on a per diem (per day) basis A0090 Non-emergency transportation, per mile - vehicle provided by individual (e.g., family member, volunteer) with a vested interest....

Are you a community mental health center that provides PHP services and transportation? Then this blog post is for you! Proper Coding: H0035-Mental Health Partial Hospitalization (PHP) treatment, l…

04/26/2026

Molina Health newsletter claim reconsideration/appeal process

The new process is available through Availity. What changed? Only 2 simple options available: claim payment inquiry/reconsideration and claim payment dispute/appeal. Claim payment Inqury- this option should be used for the following: Retro eligibility issues COB- coordination of benefits Claim denied as a duplicate in error Auth denied for no auth on file and the service doesn't require an auth or there is an auth on file- yet the claim got denied…...

The new process is available through Availity. What changed? Only 2 simple options available: claim payment inquiry/reconsideration and claim payment dispute/appeal. Claim payment Inqury- this opt…

04/25/2026

Michigan Medicaid: Community health workers billing

This blog post is educate the providers how to properly bill for community health workers. The blog post applies to services provided in Federally Qualified Health Centers (FQHCs). Proper Billing: UB-04 claim form- attending NPI- Type 1- individual sole provider Box 80- indicate the services performed- using the 4 digit code- click here to get the list Modifier- CG- required for community health workers…...

This blog post is educate the providers how to properly bill for community health workers. The blog post applies to services provided in Federally Qualified Health Centers (FQHCs). Proper Billing: …

04/25/2026

Healthfirst-new DME third party vendor

Effective for DOS 6/1/26- Integra Partners will manage all prior authorizations for DMEPOS provider requests. This new update applies to all Healthfirst plan types. There is an update DMEPOS authorization list that can be found here. Some of the DMEPOS that require an auth and a request needs to be sent to Integra Partners: Oxygen Supplies and equipment Wheelchair and accessories…...

Effective for DOS 6/1/26- Integra Partners will manage all prior authorizations for DMEPOS provider requests. This new update applies to all Healthfirst plan types. There is an update DMEPOS author…

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Yonkers, NY
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Tuesday 9am - 11am
Wednesday 9am - 12pm
Thursday 9am - 5pm
Friday 9am - 11am

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