In Audit
Mar 6th, 2019
If  you receive Additional Documentation Requests (ADR) from a Medicare Administrative Contractors (MAC) and others, here are some tips  to respond most effectively. Additional Documentation Request Success Isn’t that Hard CGS  Administrators, a MAC and Durable Medicare Administrative Contractor (DMAC) with a presence in 38 states, offers helpful tips in their ADR process.  ADRs may ...
In Audit
Mar 5th, 2019
Separately billing routine evaluation and management (E/M) services provided on the same day as another medical procedure is typically denied by Medicare. Healthcare providers may sometimes separately bill E/M services if they meet certain criteria and append modifier 25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care ...
In Audit
Mar 4th, 2019
Follow this step-by-step guide to coding and documentation compliance. It’s always better for a facility to find compliance issues before a government agency or payer does (who may respond by levying penalties and fines). Pre- or post-bill audits help facilities uncover minor concerns before they become major compliance issues, thereby promoting revenue integrity. Here’s how ...
Self audits are an important step that medical organizations of all types can take to protect themselves from potential lost revenue (or worse) by identifying coding, billing, and documentation problems before a payer does. All practices should make self-audit a part of their coding compliance program. What Self Audits Can Achieve Self audits allow you to ...
In Audit
Feb 20th, 2019
I was recently asked by a medical coder if I thought our professional services would soon become obsolete as more and more computer-assisted coding (CAC) applications are developed. I did not have to think about this for very long because CAC increasingly has been brought on line in many specialties over the past 10-15 years. ...