Follow this 12-point checklist to help you have successful medical claims reviews. Auditing is a multi-faceted appraisal that compares a patient’s medical record to a healthcare provider’s claim for medical services. Each facet must fit together to prove what was billed on the claim is completely supported in the medical record. Over the years, I ...
It’s essential and surprisingly easy when you know who to trust. New regulations, code updates, final rules, technology — ugh! Sometimes, it just seems like too much to manage, doesn’t it? The trick is to filter out all the white noise and hone in on just the information you need. At AAPC, we do this ...
Arm against fraud risks EHRs pose, and develop policies to reinforce compliance. Electronic health records (EHRs) make documentation more legible, but they also make it easier to inflate content. Evaluation and management (E/M) documentation is especially prone to EHR shortcomings because of the repetitive nature of these services. Let’s consider the risks and resolutions. Authenticate ...
In Audit
Aug 1st, 2017
Effective June 23, the Centers for Medicare & Medicaid Services (CMS) changed its locum tenens policy, and expanded it to include physical therapists. Section 1842(b)(6)(D) of the Social Security Act allows payment for physician services provided by a physician other than the patient’s physician when the patient’s physician is unavailable. The policy covers both informal ...