Provider Newsletter ABOUT YOUR HEALTH is published as a service for members of the EL PASO HEALTH Provider network. EL PASO HEALTH Executive Offices are located at 1145 Westmoreland Drive, El Paso, TX 79925, 915-532-3778 or 1-877-532-3778, elpasohealth.com. Information in ABOUT YOUR HEALTH comes from a wide range of medical experts. If you have any concerns or questions about specific content in this newsletter, call 1-877-532-3778. Models may be used in photos and illustrations. Member Services 1-877-532-3778 EPHP111382605 - EPH-PR-Summer 2026 Provider Newsletter 2026 © Coffey Communications, Inc. All rights reserved. WHY THEY MATTER FOR PROVIDERS Accurate billing is essential for both compliance and financial stability. For example, your reimbursement can be affected by your adherence to National Correct Coding Initiative (NCCI) medically unlikely edits (MUE). These limits, established by the Centers for Medicare & Medicaid Services, define the maximum number of units typically allowed on a single date of service. MUE help prevent billing errors, reduce improper payments, and promote consistent coding. However, noncompliance can create financial and operational challenges. Claims billed above MUE limits may be denied or reduced. This can result in lost revenue, increased accounts receivable (A / R) days, and additional administrative work. Repeated errors can also increase staff workload, slow your revenue cycle, and elevate audit or compliance risk. While both Medicare and Medicaid use MUE limits, Medicaid programs may apply stricter or state-specific limits. That means that a service allowed under Medicare may still be denied under Medicaid, depending on state rules or program policies. To reduce denials and protect reimbursement, Providers are encouraged to verify MUE limits before billing. This can be accomplished by incorporating MUE checks into billing systems, educating staff on commonly affected codes, using modifiers only when clinically appropriate, and monitoring denial trends for recurring issues. Understanding NCCI medically unlikely edits (MUE) Bottom line: MUE compliance is more than a coding requirement. It is a key strategy for minimizing denials, reducing administrative costs, and strengthening overall revenue cycle performance. stay informed
RkJQdWJsaXNoZXIy MjI2MTU5NA==