In Billing
Jun 2nd, 2014
The Centers for Medicare & Medicaid Services (CMS) released ts first annual update to the Medicare hospital charge data, or information comparing the average amount a hospital bills for services provided in connection with a similar inpatient stay or outpatient visit. CMS is also released a suite of other data products and tools aimed to ...
In Billing
Oct 1st, 2013
Danger is imminent if the chief complaint and unique documentation don’t support separately billed services. An example of so-called “split billing” is when the provider performs a physical exam and also discusses the patient’s chronic pre-existing conditions, linking the chronic diagnosis codes to the office visit and the reason for the visit (V70.0 Routine general ...
Mar 20th, 2013
By Carol Olson, CPC, CPC-H, CPC-I, CEMC, CCS, CCS-P, CCDS Medicare Advantage (MA) reimbursement can trip you up in ways you didn’t expect. If you are seeing MA patients, be mindful of opportunities and pitfalls. MA health plans are reimbursed based on beneficiaries’ chronic conditions. Submitting an inaccurate diagnosis, or a diagnosis resulting in a different ...
Aug 1st, 2012
By Holly J. Cassano, CPC Proper hierarchal condition category (HCC) classification depends on a plan’s ability to obtain accurate diagnostic HCC information and report that information accurately to the Centers for Medicare & Medicaid Services (CMS). If a plan focuses solely on disease management to decrease costs (neglecting to develop an effective HCC strategy), it ...