Medicare Compliance & Reimbursement
Compliance:
Beware of Potential New Discrimination Protections Based on Sex
Proposed rule would allow patients to sue you under Section 1557. When Congress passed... Read more
Beware of Potential New Discrimination Protections Based on Sex
Proposed rule would allow patients to sue you under Section 1557. When Congress passed... Read more
Compliance:
Watch for Additional Provisions For LEP & Disabilities, Too
Learn where you will find sample documents and translations. In a recent proposed rule... Read more
Watch for Additional Provisions For LEP & Disabilities, Too
Learn where you will find sample documents and translations. In a recent proposed rule... Read more
Claim Denials :
Eliminate the Need for Appeals with These 10 Tips
Heed what this MAC has to say and save time Instead of spending valuable time on appe... Read more
Eliminate the Need for Appeals with These 10 Tips
Heed what this MAC has to say and save time Instead of spending valuable time on appe... Read more
Reimbursement :
Have You Taken Note of the New POS Modifiers?
Anticipate imminent changes in payment for off-campus provider-based clinics. The Cent... Read more
Have You Taken Note of the New POS Modifiers?
Anticipate imminent changes in payment for off-campus provider-based clinics. The Cent... Read more
Compliance :
Stay Compliant by Knowing Which Entities to Notify in HIPAA Breaches
Jump out of HIPAA hot water before you face stiff penalties. The Health Insurance Port... Read more
Stay Compliant by Knowing Which Entities to Notify in HIPAA Breaches
Jump out of HIPAA hot water before you face stiff penalties. The Health Insurance Port... Read more
Industry Notes :
ICD-10 Glitch Sinks Some Foot Care Claims
Although most ICD-10 claims are flowing smoothly, practices are still facing glitches fo... Read more
ICD-10 Glitch Sinks Some Foot Care Claims
Although most ICD-10 claims are flowing smoothly, practices are still facing glitches fo... Read more
Reader Question :
You Can't Fill Out F2F Form for Docs, MAC Warns
Question: We have a client that we are providing home skilled nursing care for and ... Read more
You Can't Fill Out F2F Form for Docs, MAC Warns
Question: We have a client that we are providing home skilled nursing care for and ... Read more
Compliance:
Get Ready: See What New Target Areas Are in the OIG's Crosshairs for 2016
Why hospitals, nursing homes, and DMEPOS suppliers are in the limelight. On Nov. 2, th... Read more
Get Ready: See What New Target Areas Are in the OIG's Crosshairs for 2016
Why hospitals, nursing homes, and DMEPOS suppliers are in the limelight. On Nov. 2, th... Read more
Audit:
Hit List: Beware of OIG's Ongoing Audit Activities
Prescription drugs are a hot topic under Medicare Part B, too. Just because the HHS Of... Read more
Hit List: Beware of OIG's Ongoing Audit Activities
Prescription drugs are a hot topic under Medicare Part B, too. Just because the HHS Of... Read more
Physician Fee Schedule:
Collect for Discussing End-of-Life Options
The biggest bonus the Centers for Medicare & Medicaid Services (CMS) has for physici... Read more
Collect for Discussing End-of-Life Options
The biggest bonus the Centers for Medicare & Medicaid Services (CMS) has for physici... Read more
MA Reimbursement:
Learn How CMS' Transformed Payment System Could Impact You
VBID aims to reduce costs and improve care. With the Centers for Medicare & Medica... Read more
Learn How CMS' Transformed Payment System Could Impact You
VBID aims to reduce costs and improve care. With the Centers for Medicare & Medica... Read more
Medicare Advantage:
CMS to Scrutinize VBID Participants
The new Value-Based Insurance Design (VBID) model for Medicare Advantage (MA) Plans appe... Read more
CMS to Scrutinize VBID Participants
The new Value-Based Insurance Design (VBID) model for Medicare Advantage (MA) Plans appe... Read more
Part B Mythbuster:
Clarify These Non-Par Misconceptions Before You Land in Hot Water
Recognize the difference between opting out and being a non-par provider. Once you dec... Read more
Clarify These Non-Par Misconceptions Before You Land in Hot Water
Recognize the difference between opting out and being a non-par provider. Once you dec... Read more
Quality of Care:
Brace Yourself for New Scrutiny of Your 'Two-Midnight Rule' Compliance
What you should do before submitting claims to reduce your risk. The Centers for Medic... Read more
Brace Yourself for New Scrutiny of Your 'Two-Midnight Rule' Compliance
What you should do before submitting claims to reduce your risk. The Centers for Medic... Read more
Medical Reviews:
Your Response Time is Now Cut in Half for Quality of Care Reviews
Why you should fax, not snail-mail, medical records to your QIO. When someone files a ... Read more
Your Response Time is Now Cut in Half for Quality of Care Reviews
Why you should fax, not snail-mail, medical records to your QIO. When someone files a ... Read more
ICD-10 Implementation:
Bogey of ICD-10 Belied by Smooth Transition
All the hoopla about ICD-10 transition reminiscent of Y2K. Few healthcare providers wo... Read more
Bogey of ICD-10 Belied by Smooth Transition
All the hoopla about ICD-10 transition reminiscent of Y2K. Few healthcare providers wo... Read more
NGS Makes 'Mass Adjustment'
After Donelle Holle reported that she was seeing instances of Z23 (Encounter... Read more
After Donelle Holle reported that she was seeing instances of Z23 (Encounter... Read more
Reimbursement/Policy:
Meet New Requirement Set by NOTICE with Significant Operational Steps
Implications with respect to cost sharing and subsequent SNF eligibility must be clearly... Read more
Meet New Requirement Set by NOTICE with Significant Operational Steps
Implications with respect to cost sharing and subsequent SNF eligibility must be clearly... Read more
Home Health Prospective Payment System:
More Woes for HHAs Come Jan. 1
The 1.4-percent cut means you’ll have to make do with less. Experts fear that ma... Read more
More Woes for HHAs Come Jan. 1
The 1.4-percent cut means you’ll have to make do with less. Experts fear that ma... Read more
Industry Note:
CMS: 90 Percent of ICD-10 Claims Have Been Accepted So Far
ICD-10 has only been in effect for a little more than a month, but the Centers for Medic... Read more
CMS: 90 Percent of ICD-10 Claims Have Been Accepted So Far
ICD-10 has only been in effect for a little more than a month, but the Centers for Medic... Read more
Industry Note:
Even Obamacare is at Risk of Fraud
You’ve heard about Medicare fraud and even vulnerabilities in Medicaid and Tricare... Read more
Even Obamacare is at Risk of Fraud
You’ve heard about Medicare fraud and even vulnerabilities in Medicaid and Tricare... Read more
Reader Question:
Will You Violate HIPAA if You Report Illegal Immigrants?
Question: If our medical office reports someone who is an illegal immigrant, is thi... Read more
Will You Violate HIPAA if You Report Illegal Immigrants?
Question: If our medical office reports someone who is an illegal immigrant, is thi... Read more
Medicare Advantage:
How VBID Testing Could Revolutionize MA Reimbursement
Model focuses on treatment of most expensive and common chronic diseases. As the Medic... Read more
How VBID Testing Could Revolutionize MA Reimbursement
Model focuses on treatment of most expensive and common chronic diseases. As the Medic... Read more
VBID:
Watch Out: CMS Will Keep a Close Eye on VBID Participants
‘Secret shoppers’ are part of the federal government’s arsenal. The ... Read more
Watch Out: CMS Will Keep a Close Eye on VBID Participants
‘Secret shoppers’ are part of the federal government’s arsenal. The ... Read more
ICD-10:
Don't Let Up on ICD-10 Training After Transition
Take the lead in planning ICD-10 learning activities. With Oct. 1, 2015 behind us, exp... Read more
Don't Let Up on ICD-10 Training After Transition
Take the lead in planning ICD-10 learning activities. With Oct. 1, 2015 behind us, exp... Read more
Electronic Health Records:
Doctors' Dissatisfaction with EHR Issues Holds Lessons for You
Surprisingly, EHRs adding to difficulties instead of reducing workload, says study. A ... Read more
Doctors' Dissatisfaction with EHR Issues Holds Lessons for You
Surprisingly, EHRs adding to difficulties instead of reducing workload, says study. A ... Read more
Industry Note:
CMS Dedicates Tens of Millions to Reducing Hospitalizations in Newest Funding Push
A new funding push to reduce hospital readmissions underscores the measure’s impor... Read more
CMS Dedicates Tens of Millions to Reducing Hospitalizations in Newest Funding Push
A new funding push to reduce hospital readmissions underscores the measure’s impor... Read more
Industry Note:
ACA Seeks Medicare Parity for Chiropractic Services
Medicare parity is a top legislative and regulatory priority for the American Chiropract... Read more
ACA Seeks Medicare Parity for Chiropractic Services
Medicare parity is a top legislative and regulatory priority for the American Chiropract... Read more
Industry Note:
ICD-10 Glitch Takes Down Home Health Claims
Sit tight for adjustments, Medicare Administrative Contractors instruct. Home care provi... Read more
ICD-10 Glitch Takes Down Home Health Claims
Sit tight for adjustments, Medicare Administrative Contractors instruct. Home care provi... Read more
Industry Note:
This MAC Wants Signatures on Appeals
Don’t shoot yourself in the foot on your Medicare claims appeals. “A paper a... Read more
This MAC Wants Signatures on Appeals
Don’t shoot yourself in the foot on your Medicare claims appeals. “A paper a... Read more
Reader Question:
Don't Count on Pay for 99051
Question: We are looking to hire a pediatrician, but in the meantime our schedule i... Read more
Don't Count on Pay for 99051
Question: We are looking to hire a pediatrician, but in the meantime our schedule i... Read more
Reader Question:
No Problem, No Face-to-Face Visit, No Code
Question: A parent of a large family came into the office with two sick children wh... Read more
No Problem, No Face-to-Face Visit, No Code
Question: A parent of a large family came into the office with two sick children wh... Read more
Claims Appeals:
Good News: You Now Have Better Appeal Chances for Certain Denied Claims
But make sure you pay attention to the many limitations on the new guidance. In a refr... Read more
Good News: You Now Have Better Appeal Chances for Certain Denied Claims
But make sure you pay attention to the many limitations on the new guidance. In a refr... Read more
Claims Reviews:
How the New Guidance is Especially Positive for Therapy Appeals
Understand how review limitation will affect your over-cap therapy claims. If you&rsqu... Read more
How the New Guidance is Especially Positive for Therapy Appeals
Understand how review limitation will affect your over-cap therapy claims. If you&rsqu... Read more
Error Rates:
Questionable Billing Seems to Have A Geographic Pattern
OIG advise CMS to closely monitor ophthalmology claims. The HHS Office of the Inspecto... Read more
Questionable Billing Seems to Have A Geographic Pattern
OIG advise CMS to closely monitor ophthalmology claims. The HHS Office of the Inspecto... Read more
Reimbursement:
Get the Lowdown on the 2-Midnight Rule
Safeguard your facility from RAC audits. If patients receiving identical services are... Read more
Get the Lowdown on the 2-Midnight Rule
Safeguard your facility from RAC audits. If patients receiving identical services are... Read more
Compliance:
Watch Out for Disparity in Admission Status of Similar Patients
Learn to distinguish between observation and inpatient services. “We do not beli... Read more
Watch Out for Disparity in Admission Status of Similar Patients
Learn to distinguish between observation and inpatient services. “We do not beli... Read more
Federal Register on Condition Code 44
“As we stated for the Condition Code 44 policy (MCPM, Chapter 1, Section 50.3.1), ... Read more
“As we stated for the Condition Code 44 policy (MCPM, Chapter 1, Section 50.3.1), ... Read more
HIPAA:
Meet 4 Important Criteria to Qualify as a Whistleblower
Disclosure of PHI to attorneys to obtain legal options not a violation of HIPAA, says co... Read more
Meet 4 Important Criteria to Qualify as a Whistleblower
Disclosure of PHI to attorneys to obtain legal options not a violation of HIPAA, says co... Read more
Industry Note:
CMS: Using Our Free Billing Software Doesn't Excuse You from ICD-10
If your claim submission software is preventing you from submitting ICD-10 codes on your... Read more
CMS: Using Our Free Billing Software Doesn't Excuse You from ICD-10
If your claim submission software is preventing you from submitting ICD-10 codes on your... Read more
Industry Notes:
Medical Biller Lands in Prison for Her Role in Fraud Scheme
If you thought the government only went after medical practitioners for fraud, think aga... Read more
Medical Biller Lands in Prison for Her Role in Fraud Scheme
If you thought the government only went after medical practitioners for fraud, think aga... Read more
Reimbursement:
'Prosecutorial Discretion' Could Save You from Overpayment Penalties -- Here's How
Could your diligent and faithful actions bail you out on day 61? You must start prepar... Read more
'Prosecutorial Discretion' Could Save You from Overpayment Penalties -- Here's How
Could your diligent and faithful actions bail you out on day 61? You must start prepar... Read more
Overpayments:
Look Ahead: 3 Potential After Effects from Overpayment Case
Plus, what steps you should take now to protect yourself from enforcement actions. As ... Read more
Look Ahead: 3 Potential After Effects from Overpayment Case
Plus, what steps you should take now to protect yourself from enforcement actions. As ... Read more
Audits:
Does Your Documentation Support Services Billed?
E/M coding still tripping up reimbursement. If 73.3 percent of your claims were denied... Read more
Does Your Documentation Support Services Billed?
E/M coding still tripping up reimbursement. If 73.3 percent of your claims were denied... Read more
Medical Reviews:
New Review Entities on the Horizon
CMS proposes switch. You’ll be getting medical reviews from a new entity for ... Read more
New Review Entities on the Horizon
CMS proposes switch. You’ll be getting medical reviews from a new entity for ... Read more
PHI:
Keep Looking for New Ways To Secure Data
Growing number of breaches in 2015 indicate continuing vulnerability. Accidental losse... Read more
Keep Looking for New Ways To Secure Data
Growing number of breaches in 2015 indicate continuing vulnerability. Accidental losse... Read more
Industry Note:
White House: CMS Not Making Enough Effort to Fix Errors
Although it might feel like CMS is doing everything it can to keep money ... Read more
White House: CMS Not Making Enough Effort to Fix Errors
Although it might feel like CMS is doing everything it can to keep money ... Read more
Industry Note:
Cost Report Changes Afoot for Variety of Hospice Types
The Centers for Medicare & Medicaid Services (CMS) may have issued freestanding hosp... Read more
Cost Report Changes Afoot for Variety of Hospice Types
The Centers for Medicare & Medicaid Services (CMS) may have issued freestanding hosp... Read more
Industry Note:
Submit F2F for All Reviewed Claims -- Even Recerts
Don’t forget that medical reviewers will be poring over your claims for face-to-fa... Read more
Submit F2F for All Reviewed Claims -- Even Recerts
Don’t forget that medical reviewers will be poring over your claims for face-to-fa... Read more
Reimbursement:
Get Paid for 'The Talk' With Seriously Ill Patients -- Here's How
But does no national coverage determination mean no reliable payments? Conversations w... Read more
Get Paid for 'The Talk' With Seriously Ill Patients -- Here's How
But does no national coverage determination mean no reliable payments? Conversations w... Read more
Physician Fee Schedule:
Pay Attention to Other Key Issues in Physician Fee Schedule Proposed Rule
CMS geared to move forward with value-based payment modifier program. The introductio... Read more
Pay Attention to Other Key Issues in Physician Fee Schedule Proposed Rule
CMS geared to move forward with value-based payment modifier program. The introductio... Read more
ICD-10 Transition:
Take MAC's Help for ICD-10 Alternate Billing if You Face Issues
Years of preparation to bear fruit now. The switch to ICD-10 is almost here. However,... Read more
Take MAC's Help for ICD-10 Alternate Billing if You Face Issues
Years of preparation to bear fruit now. The switch to ICD-10 is almost here. However,... Read more
ICD-10:
Prepare for Dual Coding on Workers' Comp Claims
Not all states are switching to ICD-10. Effective Oct. 1, you might need to use both ... Read more
Prepare for Dual Coding on Workers' Comp Claims
Not all states are switching to ICD-10. Effective Oct. 1, you might need to use both ... Read more
CMS Names Rogers ICD-10 Ombudsman
Anyone who has participated in a CMS open door forum is familiar with the name William R... Read more
Anyone who has participated in a CMS open door forum is familiar with the name William R... Read more
Tricare Claims:
Navigate Tricare-Specific Rules With 5 Tips
Tip: Keep an eye open for services this payer does not cover. If your practice sees th... Read more
Navigate Tricare-Specific Rules With 5 Tips
Tip: Keep an eye open for services this payer does not cover. If your practice sees th... Read more
Industry Notes
You Can Keep Using DSM-IV and V Under ICD-10 Mental health professionals already consu... Read more
You Can Keep Using DSM-IV and V Under ICD-10 Mental health professionals already consu... Read more
Reimbursement:
Get More Medicare Pay for Concurrently Providing Hospice & Curative Services
Tip: Hospices aren’t the only provider type that can earn extra reimbursement. A... Read more
Get More Medicare Pay for Concurrently Providing Hospice & Curative Services
Tip: Hospices aren’t the only provider type that can earn extra reimbursement. A... Read more
Despite Enthusiasm, Here's Why Some Say MCCM Isn't a Bed of Roses
Should patients with these diagnoses be included in the MCCM project, too? Although mo... Read more
Should patients with these diagnoses be included in the MCCM project, too? Although mo... Read more
Compliance:
Establish a Culture of Compliance
Understand what the OIG expects from healthcare governing boards. You need to regularl... Read more
Establish a Culture of Compliance
Understand what the OIG expects from healthcare governing boards. You need to regularl... Read more
Compliance:
Handle Compliance Issues Deftly with OIG's Help
Tip: Self-identification reduces potential fallout. Should you find you or your organi... Read more
Handle Compliance Issues Deftly with OIG's Help
Tip: Self-identification reduces potential fallout. Should you find you or your organi... Read more
Patient Privacy:
Is New Technology Leaving Your Organization Open to HIPAA Violations?
Learn from this hospital’s experience. Using web-based document sharing applicat... Read more
Is New Technology Leaving Your Organization Open to HIPAA Violations?
Learn from this hospital’s experience. Using web-based document sharing applicat... Read more
Audits:
Avoid the RAC Auditor Spotlight on E/M, Hydration Therapy
Identify when you need to attach modifier 25 to an E/M service. These days, it isn&rsq... Read more
Avoid the RAC Auditor Spotlight on E/M, Hydration Therapy
Identify when you need to attach modifier 25 to an E/M service. These days, it isn&rsq... Read more
ICD-10 Transition:
Home Health Providers Protest Physicians' Sweetheart Deal
Home care and hospice providers tell CMS they deserve more leniency. In guidance poste... Read more
Home Health Providers Protest Physicians' Sweetheart Deal
Home care and hospice providers tell CMS they deserve more leniency. In guidance poste... Read more
Industry Notes
RN, LPN G Codes for Hospice Won’t be Out for a While Hospices have a lot to do t... Read more
RN, LPN G Codes for Hospice Won’t be Out for a While Hospices have a lot to do t... Read more
ICD-10:
Enjoy 4 New Provisions That Will Greatly Ease Your Transition to ICD-10
One-year grace period is good, but two years would be better, some say. Errors in your... Read more
Enjoy 4 New Provisions That Will Greatly Ease Your Transition to ICD-10
One-year grace period is good, but two years would be better, some say. Errors in your... Read more
ICD-10 Resources:
Beef Up Your ICD-10 Coding Knowledge with These New Resources
Upcoming national provider call aims to provide a wealth of information. The transitio... Read more
Beef Up Your ICD-10 Coding Knowledge with These New Resources
Upcoming national provider call aims to provide a wealth of information. The transitio... Read more
ICD-10:
Take Advantage of CMS's Latest ICD-10 Clarifications
If you are confused, you can check out FAQs on the CMS site. You probably heaved a sig... Read more
Take Advantage of CMS's Latest ICD-10 Clarifications
If you are confused, you can check out FAQs on the CMS site. You probably heaved a sig... Read more
Hospital Billing Strategy:
Develop Strong Business Relationships to Ensure Smooth Reimbursement Claims
Tip: Get a good EHR solution with outstanding reporting and coding facilitation features... Read more
Develop Strong Business Relationships to Ensure Smooth Reimbursement Claims
Tip: Get a good EHR solution with outstanding reporting and coding facilitation features... Read more
Part A Funding:
Future of Medicare Part A Under a Cloud
Good news: CMS has learned how to stretch a dollar. That Medicare Part A needs additio... Read more
Future of Medicare Part A Under a Cloud
Good news: CMS has learned how to stretch a dollar. That Medicare Part A needs additio... Read more
Industry Notes
Physician Kickbacks Lead to Jail Time The feds continue to crack down on home care and... Read more
Physician Kickbacks Lead to Jail Time The feds continue to crack down on home care and... Read more
Reader Question:
Is it a Breach if PHI Doesn't Leave the Facility?
Question: An employee at our hospital accessed records for which he had no legitima... Read more
Is it a Breach if PHI Doesn't Leave the Facility?
Question: An employee at our hospital accessed records for which he had no legitima... Read more
Enforcement News:
How The Latest Massive Medicare Fraud Takedown Is Changing Enforcement
Beware: Medicare Part D now under scrutiny for upcoming fraud actions. The biggest Med... Read more
How The Latest Massive Medicare Fraud Takedown Is Changing Enforcement
Beware: Medicare Part D now under scrutiny for upcoming fraud actions. The biggest Med... Read more
What the OIG is Scrutinizing Regarding Medicare Part D Billing
Watch prescriptions for ‘commonly abused opioids.’ Since 2006, Medicare sp... Read more
Watch prescriptions for ‘commonly abused opioids.’ Since 2006, Medicare sp... Read more
Part B Payment:
New Codes Without Pay Attached, 0.5 Percent Pay Increase Come January
Good news: You won’t face payment insecurity issues in 2016. The Centers for Med... Read more
New Codes Without Pay Attached, 0.5 Percent Pay Increase Come January
Good news: You won’t face payment insecurity issues in 2016. The Centers for Med... Read more
CMS Dips Toe Into MACRA Shift
As most practices know, the Centers for Medicare & Medicaid Services (CMS) is planni... Read more
As most practices know, the Centers for Medicare & Medicaid Services (CMS) is planni... Read more
ICD-10 Update:
Physician Payments Linked to Procedure, Not Diagnosis
Hint: ICD-10-CM defines diagnosis coding. Your Medicare payments could be at stake unl... Read more
Physician Payments Linked to Procedure, Not Diagnosis
Hint: ICD-10-CM defines diagnosis coding. Your Medicare payments could be at stake unl... Read more
Industry Notes:
Does Your Employee Confidentiality Policy Violate The NLRA?
Even if your employee’s conduct violates HIPAA, that doesn’t mean terminatin... Read more
Does Your Employee Confidentiality Policy Violate The NLRA?
Even if your employee’s conduct violates HIPAA, that doesn’t mean terminatin... Read more
Industry Notes:
CMS' Analytics System Caught $820 Million in Fraud
CMS uses many approaches to catching fraud, and its high-tech analytics system is one of... Read more
CMS' Analytics System Caught $820 Million in Fraud
CMS uses many approaches to catching fraud, and its high-tech analytics system is one of... Read more
Reader Question:
Medicare Shares ICD-10 Help With Road to 10
Question: Our entire office is pitching in to prepare for the switch over to ICD-10... Read more
Medicare Shares ICD-10 Help With Road to 10
Question: Our entire office is pitching in to prepare for the switch over to ICD-10... Read more
Reader Question:
Is it Critical for the ED Physician To Document a Full History for Code 99291?
Question: Does the emergency department (ED) physician need to complete all the HPI... Read more
Is it Critical for the ED Physician To Document a Full History for Code 99291?
Question: Does the emergency department (ED) physician need to complete all the HPI... Read more
Reimbursement:
ACOs: Understand The 5 Big Changes In The MSSP Final Rule
New Track 3 encourages more risk and reaps bigger rewards. The Centers for Medicare &a... Read more
ACOs: Understand The 5 Big Changes In The MSSP Final Rule
New Track 3 encourages more risk and reaps bigger rewards. The Centers for Medicare &a... Read more
Get A Clear Picture Of The Major MSSP Modifications
Learn how the three tracks now differ. The new Medicare Shared Savings Program (MSSP) ... Read more
Learn how the three tracks now differ. The new Medicare Shared Savings Program (MSSP) ... Read more
Home Health Reimbursement:
Value-Based Purchasing Steals The Show
Expect payment to take a hit. Home health agencies’ worst nightmares seem to be ... Read more
Value-Based Purchasing Steals The Show
Expect payment to take a hit. Home health agencies’ worst nightmares seem to be ... Read more
Value-Based Purchasing:
Is Your State In The Pilot?
Even if it’s not now, it may be by the fall. If your state is in Medicare’... Read more
Is Your State In The Pilot?
Even if it’s not now, it may be by the fall. If your state is in Medicare’... Read more
Coverage & Reimbursement:
You Could Be Missing Vital Information If You Overlook LCDs
Tip: Your reimbursement is contingent upon your service being covered. When you’... Read more
You Could Be Missing Vital Information If You Overlook LCDs
Tip: Your reimbursement is contingent upon your service being covered. When you’... Read more
Home Health Reimbursement:
Bigger Cuts Threaten HHAs' Existence
Latest Medicare rate update brings bad news for home health agencies. The Centers for ... Read more
Bigger Cuts Threaten HHAs' Existence
Latest Medicare rate update brings bad news for home health agencies. The Centers for ... Read more
Industry Notes:
Medicare Opt-Outs Now Auto-Renew Every 2 Years
If you’ve been opting out of Medicare every two years, CMS has either great news o... Read more
Medicare Opt-Outs Now Auto-Renew Every 2 Years
If you’ve been opting out of Medicare every two years, CMS has either great news o... Read more
Reimbursement:
Avoid Making 7 Common Mistakes When Billing for Chronic Care Management
Don’t try to bill certain services during the same month as CCM. If you’re... Read more
Avoid Making 7 Common Mistakes When Billing for Chronic Care Management
Don’t try to bill certain services during the same month as CCM. If you’re... Read more
Learn From CCM FAQs to Prevent Claims Denials
Why an answering machine won’t meet the 24/7 requirement. When it comes to billi... Read more
Why an answering machine won’t meet the 24/7 requirement. When it comes to billi... Read more
Compliance:
Watch Your POS Coding or Invite Scrutiny
Tip: Avoid this problem by educating your staff on the differences between the POS codes... Read more
Watch Your POS Coding or Invite Scrutiny
Tip: Avoid this problem by educating your staff on the differences between the POS codes... Read more
Place of Service:
Use This Quick Guide to Pinpoint POS Codes
If you think you might be at risk of making place of service (POS) errors like the OIG f... Read more
Use This Quick Guide to Pinpoint POS Codes
If you think you might be at risk of making place of service (POS) errors like the OIG f... Read more
Bilateral Billing:
You Could Spend Hours on Bilateral Service Appeals
CMS confirms a pattern of inappropriate billing using multiple lines to bypass the MUEs.... Read more
You Could Spend Hours on Bilateral Service Appeals
CMS confirms a pattern of inappropriate billing using multiple lines to bypass the MUEs.... Read more
Studies & Surveys:
Medicare Costs Rising With Hospice Patients In Nursing Homes
Aggressive care also needed. A new study published in the New England Journal of ... Read more
Medicare Costs Rising With Hospice Patients In Nursing Homes
Aggressive care also needed. A new study published in the New England Journal of ... Read more
Industry Notes:
Wait Until October for These Home Health Payment Fixes
If you’ve seen problems with your home health agency claims re-coding incorrectly ... Read more
Wait Until October for These Home Health Payment Fixes
If you’ve seen problems with your home health agency claims re-coding incorrectly ... Read more
Reader Question:
Put 99221/99211 Confusion Behind You With a Simple Query
Question: Our provider admitted a patient for observation, but documentation of ini... Read more
Put 99221/99211 Confusion Behind You With a Simple Query
Question: Our provider admitted a patient for observation, but documentation of ini... Read more
Compliance:
Take OIG's 4 Steps On Your Path To Compliance
New guide stresses compliance in healthcare organizations as a ‘way of life.&rsquo... Read more
Take OIG's 4 Steps On Your Path To Compliance
New guide stresses compliance in healthcare organizations as a ‘way of life.&rsquo... Read more
Consider Self-Disclosure To Ease Noncompliance Fallout
OIG identifies three distinct benefits of self-reporting. As part of the newly publish... Read more
OIG identifies three distinct benefits of self-reporting. As part of the newly publish... Read more
Compliance:
Overbill And Risk Paybacks Down The Road
If your reimbursement seems too good to be true, it probably is. Two providers that we... Read more
Overbill And Risk Paybacks Down The Road
If your reimbursement seems too good to be true, it probably is. Two providers that we... Read more
Compliance:
Invite Attention From Auditors With Missing Medical Records
Lookout for claim viability if your physicians perform these services. Scrutiny of pol... Read more
Invite Attention From Auditors With Missing Medical Records
Lookout for claim viability if your physicians perform these services. Scrutiny of pol... Read more
Home Health Quality of Care:
Create Meaningful Distinctions Across Agencies, Says CMS
Get ready for the statistical clustering technique. If you thought that surveys were y... Read more
Create Meaningful Distinctions Across Agencies, Says CMS
Get ready for the statistical clustering technique. If you thought that surveys were y... Read more
Industry Notes:
Congress to Vote on IPAB Repeal
Most Part B practices have gotten the hang of the Affordable Care Act (ACA) provisions &... Read more
Congress to Vote on IPAB Repeal
Most Part B practices have gotten the hang of the Affordable Care Act (ACA) provisions &... Read more
Industry Notes:
No Family History? Explain Why
It happens from time to time — you’re filling out a thorough E/M record, but... Read more
No Family History? Explain Why
It happens from time to time — you’re filling out a thorough E/M record, but... Read more
Industry Notes:
Government Fights EHR 'Information Blocking'
On the one hand, the government is pushing all medical practices to adopt electronic hea... Read more
Government Fights EHR 'Information Blocking'
On the one hand, the government is pushing all medical practices to adopt electronic hea... Read more
Industry Notes:
Misdiagnosis Leads To Fraud Settlement
A Florida neurologist agreed to pay $150,000 to the government on May 20 to settle alleg... Read more
Misdiagnosis Leads To Fraud Settlement
A Florida neurologist agreed to pay $150,000 to the government on May 20 to settle alleg... Read more
Reader Question:
Know Rules For Patient Access To Records
Question: I want to see my medical records — why do I not have access to them... Read more
Know Rules For Patient Access To Records
Question: I want to see my medical records — why do I not have access to them... Read more
Appeals:
How OMHA's Medicare Appeals Process Could Soon Change Drastically
Be patient: Cutting your losses and taking 68% isn’t the answer, experts say. Th... Read more
How OMHA's Medicare Appeals Process Could Soon Change Drastically
Be patient: Cutting your losses and taking 68% isn’t the answer, experts say. Th... Read more
Brace Yourself For Extraordinary OMHA Timeframes
Expect average processing time for appeals decisions to exceed 540 days. Due to the ov... Read more
Expect average processing time for appeals decisions to exceed 540 days. Due to the ov... Read more
Privacy:
Safeguard Your Medical Identity In 8 Steps
Compromised NPI could land you with fraud charges. Medicare beneficiaries and provider... Read more
Safeguard Your Medical Identity In 8 Steps
Compromised NPI could land you with fraud charges. Medicare beneficiaries and provider... Read more
Part B Mythbuster:
Missing Signature Could Cost You
Tip: Create a signature log to protect your payments during an audit. Your physician&r... Read more
Missing Signature Could Cost You
Tip: Create a signature log to protect your payments during an audit. Your physician&r... Read more
Industry Notes:
This MAC Warns Against Vague Unlisted, NOC Claims
Sometimes it’s inevitable — your CPT® or ICD-9 manuals don’t inclu... Read more
This MAC Warns Against Vague Unlisted, NOC Claims
Sometimes it’s inevitable — your CPT® or ICD-9 manuals don’t inclu... Read more
Industry Notes:
Wrong Surgery On A Patient? There's A Modifier For That
You may have modifiers 59 and 25 committed to memory, but you’ve also got access t... Read more
Wrong Surgery On A Patient? There's A Modifier For That
You may have modifiers 59 and 25 committed to memory, but you’ve also got access t... Read more
Industry Notes:
CMS Debuts Four New HCPCS Codes
Although you’re probably busy prepping for ICD-10 to take effect, another codeset ... Read more
CMS Debuts Four New HCPCS Codes
Although you’re probably busy prepping for ICD-10 to take effect, another codeset ... Read more
Industry Notes:
House Calls Pay Far Too Much In This Case
House calls can pay — but they can also raise red flags if you’re billing th... Read more
House Calls Pay Far Too Much In This Case
House calls can pay — but they can also raise red flags if you’re billing th... Read more
Reimbursement:
Good News: Say Goodbye To Medicare Reimbursement Uncertainty
What will happen to claims you submitted before Congress passed MACRA? Congress has gi... Read more
Good News: Say Goodbye To Medicare Reimbursement Uncertainty
What will happen to claims you submitted before Congress passed MACRA? Congress has gi... Read more
Therapy Caps:
Yes, You Still Have The Therapy Cap Exceptions Process
Industry stakeholders won’t give up the fight to eliminate cap. Although passage... Read more
Yes, You Still Have The Therapy Cap Exceptions Process
Industry stakeholders won’t give up the fight to eliminate cap. Although passage... Read more
Compliance:
Clear Up 10 Compliance Misconceptions
Heed this advice to avoid problems with the authorities. Falling for common Medicare b... Read more
Clear Up 10 Compliance Misconceptions
Heed this advice to avoid problems with the authorities. Falling for common Medicare b... Read more
Reimbursement:
Improve Documentation To Take Advantage Of Incentives
Capture chiropractic services accurately and benefit from new provisos thanks to MACRA. ... Read more
Improve Documentation To Take Advantage Of Incentives
Capture chiropractic services accurately and benefit from new provisos thanks to MACRA. ... Read more
Industry Notes:
ACOs Saved Medicare $317 Million in Two Year Study
You may be aware of the fact that the government wants to tie more Medicare payments to ... Read more
ACOs Saved Medicare $317 Million in Two Year Study
You may be aware of the fact that the government wants to tie more Medicare payments to ... Read more
Industry Notes:
Your MAC Doesn't Want A Preauthorization Request
You’d probably feel better about submitting your claims if your MAC first gave you... Read more
Your MAC Doesn't Want A Preauthorization Request
You’d probably feel better about submitting your claims if your MAC first gave you... Read more
Industry Notes:
Performing CT Scans? Don't Make These Mistakes
If you’re performing CT scans, it’s a good time to check your documentation.... Read more
Performing CT Scans? Don't Make These Mistakes
If you’re performing CT scans, it’s a good time to check your documentation.... Read more
Industry Notes:
Almost 40 Percent Of Providers Saw Pay Slashed By 1.5 Percent Due To PQRS Non-Participation
Almost half a million providers forfeited 1.5 percent of their pay this year, CMS report... Read more
Almost 40 Percent Of Providers Saw Pay Slashed By 1.5 Percent Due To PQRS Non-Participation
Almost half a million providers forfeited 1.5 percent of their pay this year, CMS report... Read more
Industry Notes:
Tune In For New Home Health F2F Form Information
Home health agencies can find out more about the newest face-to-face physician encounter... Read more
Tune In For New Home Health F2F Form Information
Home health agencies can find out more about the newest face-to-face physician encounter... Read more
ICD-10:
Final Countdown: Take 6 Steps to Prepare for October ICD-10 Transition
Tip: Try ‘dual coding’ to exercise your ICD-10 abilities. With no further ... Read more
Final Countdown: Take 6 Steps to Prepare for October ICD-10 Transition
Tip: Try ‘dual coding’ to exercise your ICD-10 abilities. With no further ... Read more
ICD-10 Transition:
ICD-10 Up-Close: Pay Attention to Family Practice Documentation Changes
Look for a whole new code set for ‘underdosing’ in ICD-10. The proverbial ... Read more
ICD-10 Up-Close: Pay Attention to Family Practice Documentation Changes
Look for a whole new code set for ‘underdosing’ in ICD-10. The proverbial ... Read more
Reimbursement:
Part B Pay Overhauled, Global Surgical Packages to Stay
Three incentive programs to be consolidated. Now that the Medicare Access and CHIP Rea... Read more
Part B Pay Overhauled, Global Surgical Packages to Stay
Three incentive programs to be consolidated. Now that the Medicare Access and CHIP Rea... Read more
Reimbursement:
Get the Lowdown on MedPac Recommendations
Severity of impact on FFS will depend on how changes are implemented. If the Medica... Read more
Get the Lowdown on MedPac Recommendations
Severity of impact on FFS will depend on how changes are implemented. If the Medica... Read more
Compliance:
Will You Be the Next Target for Repayments?
Improper payments for ESRD on auditors’ radar. The Centers for Medicare & Me... Read more
Will You Be the Next Target for Repayments?
Improper payments for ESRD on auditors’ radar. The Centers for Medicare & Me... Read more
Industry Notes:
New Medicare Cards Will Be SSN-Free
Most practices are quite aware of the fact that Medicare beneficiaries hate seeing their... Read more
New Medicare Cards Will Be SSN-Free
Most practices are quite aware of the fact that Medicare beneficiaries hate seeing their... Read more
Breaking News:
Specter Of Yearly Doc Fix Process Eliminated
ICD-10 transition still on track. President Barak Obama signed into law the Medicare A... Read more
Specter Of Yearly Doc Fix Process Eliminated
ICD-10 transition still on track. President Barak Obama signed into law the Medicare A... Read more
Compliance:
What Delay In 60-Day Overpayment Final Rule Means For You
Why one-year postponement doesn’t really give you a reprieve. You won’t se... Read more
What Delay In 60-Day Overpayment Final Rule Means For You
Why one-year postponement doesn’t really give you a reprieve. You won’t se... Read more
Overpayments:
Keep A Close Watch On These Overpayment-Related Court Cases
How outcome of lawsuits could impact 60-day rule. The fact that the Centers for Med... Read more
Keep A Close Watch On These Overpayment-Related Court Cases
How outcome of lawsuits could impact 60-day rule. The fact that the Centers for Med... Read more
Part B Revenue Booster:
Keep Cash Flow Positive With 10 Tips
Are you bleeding thousands by missing out on reimbursement opportunities? Keeping trac... Read more
Keep Cash Flow Positive With 10 Tips
Are you bleeding thousands by missing out on reimbursement opportunities? Keeping trac... Read more
Industry Notes:
OIG Recommends Removing SSNs From Medicare Cards
It’s a common complaint: You ask your patient for his Medicare card and he complai... Read more
OIG Recommends Removing SSNs From Medicare Cards
It’s a common complaint: You ask your patient for his Medicare card and he complai... Read more
Industry Notes:
This MAC Spells Out 'High Risk' MDM Component
If you’re trying to achieve a higher medical decision-making (MDM) level because y... Read more
This MAC Spells Out 'High Risk' MDM Component
If you’re trying to achieve a higher medical decision-making (MDM) level because y... Read more
Industry Notes:
Look For Final Home Health F2F Form Later This Month
You soon may find out just how easy or hard the new face-to-face physician encounter req... Read more
Look For Final Home Health F2F Form Later This Month
You soon may find out just how easy or hard the new face-to-face physician encounter req... Read more
Reimbursement:
Jump Through These Hoops To Get Medicare Payment For Lung Cancer Screening
Check criteria for determining most at-risk Medicare patients. Good news: For the firs... Read more
Jump Through These Hoops To Get Medicare Payment For Lung Cancer Screening
Check criteria for determining most at-risk Medicare patients. Good news: For the firs... Read more
Submit This Data If You Want Reimbursement For LDCT Screening
Make sure you get the ordering practitioner’s NPI. Now that the Centers for Medi... Read more
Make sure you get the ordering practitioner’s NPI. Now that the Centers for Medi... Read more
ICD-10:
Associations Fear ICD-10 Transfer Might Trigger Massive Denials
End-to-end testing reveals potential problems. If you have questions about the ICD-10 ... Read more
Associations Fear ICD-10 Transfer Might Trigger Massive Denials
End-to-end testing reveals potential problems. If you have questions about the ICD-10 ... Read more
Consolidated Billing:
Negotiate With SNF To Secure Reimbursement
Hint: Understand the nitty-gritty of consolidated billing first. If you face denials f... Read more
Negotiate With SNF To Secure Reimbursement
Hint: Understand the nitty-gritty of consolidated billing first. If you face denials f... Read more
Compliance:
EHR Fraud Vulnerabilities On OIG Hit List
Watch out: Payment threshold for manual review in the works. The HHS Office of the Ins... Read more
EHR Fraud Vulnerabilities On OIG Hit List
Watch out: Payment threshold for manual review in the works. The HHS Office of the Ins... Read more
Industry Notes:
Proposed 'Doc Fix' Could See Congressional Vote
If you were anxious that you’ll face a 21 percent reimbursement cut on April 1 if ... Read more
Proposed 'Doc Fix' Could See Congressional Vote
If you were anxious that you’ll face a 21 percent reimbursement cut on April 1 if ... Read more
Therapy:
Follow 6 Steps To Survive The Return Of Therapy MMRs
Assemble — and prepare — your ADR response team now. The Manual Medical Re... Read more
Follow 6 Steps To Survive The Return Of Therapy MMRs
Assemble — and prepare — your ADR response team now. The Manual Medical Re... Read more
What To Expect:
Understand The 5 ADR Cycles
Get ready for a series of requests that will span all of your MMR-eligible claims. Bra... Read more
Understand The 5 ADR Cycles
Get ready for a series of requests that will span all of your MMR-eligible claims. Bra... Read more
Chronic Care Management:
See An Annual Income Boost Of $10,320
Budget for these 9 factors first. The Centers for Medicare & Medicaid Services (CM... Read more
See An Annual Income Boost Of $10,320
Budget for these 9 factors first. The Centers for Medicare & Medicaid Services (CM... Read more
Compliance:
Who Can Provide Chronic Care Management?
If you’re wondering which of your practitioners can provide chronic care managemen... Read more
Who Can Provide Chronic Care Management?
If you’re wondering which of your practitioners can provide chronic care managemen... Read more
ICD-10:
Most Health Care Providers Poised To Make a Successful Transition to ICD-10
Do you know when you’ll need to report ICD-9 codes, even after the ICD-10 deadline... Read more
Most Health Care Providers Poised To Make a Successful Transition to ICD-10
Do you know when you’ll need to report ICD-9 codes, even after the ICD-10 deadline... Read more
Industry Notes:
Are You Being Double-Penalized for EHR Non-Participation?
As if taking a one percent hit on your Medicare payments isn’t painful enough, som... Read more
Are You Being Double-Penalized for EHR Non-Participation?
As if taking a one percent hit on your Medicare payments isn’t painful enough, som... Read more
Reader Question:
Home Health Care and Billing Appropriate HCPCS Codes
Question: Our physician recently contacted a home health care agency to plan and pr... Read more
Home Health Care and Billing Appropriate HCPCS Codes
Question: Our physician recently contacted a home health care agency to plan and pr... Read more
Reimbursement:
Get Ready For Your Payments To Switch From Volume To Value
Make sure your EHR system can handle this substantial change. All those rumblings abou... Read more
Get Ready For Your Payments To Switch From Volume To Value
Make sure your EHR system can handle this substantial change. All those rumblings abou... Read more
Value-Based Payment Timeline:
What To Expect & When
CMS wants transition to occur in the next one to three years. Moving the Medicare prog... Read more
What To Expect & When
CMS wants transition to occur in the next one to three years. Moving the Medicare prog... Read more
Part B Coverage:
New Medicare Preventive Benefit Covers Cancer Screening
CMS takes bold step to reduce lung cancer mortality of patients. The Centers for Medic... Read more
New Medicare Preventive Benefit Covers Cancer Screening
CMS takes bold step to reduce lung cancer mortality of patients. The Centers for Medic... Read more
Terminology:
Know the Lingo to Determine Who Qualifies as an NPP
Once you can clearly define non-physician practitioner (NPP), also referred to as or non... Read more
Know the Lingo to Determine Who Qualifies as an NPP
Once you can clearly define non-physician practitioner (NPP), also referred to as or non... Read more
Part B Revenue Booster:
Capture Incident-to Services and Maximize Your Income
Find out what you might have missed on incident-to billing. Are you certain that every... Read more
Capture Incident-to Services and Maximize Your Income
Find out what you might have missed on incident-to billing. Are you certain that every... Read more
Industry Notes:
ICD-10 Still on Track for October, Despite Congressional Hearing
If you’re ready to make the ICD-10 conversion, Congress appears to have your back ... Read more
ICD-10 Still on Track for October, Despite Congressional Hearing
If you’re ready to make the ICD-10 conversion, Congress appears to have your back ... Read more
Surveys:
Providers Fed Up, Quality Initiatives Found Counter-Productive
MGMA gets real about PQRS, value-based modifier. Many medical professionals feel like ... Read more
Providers Fed Up, Quality Initiatives Found Counter-Productive
MGMA gets real about PQRS, value-based modifier. Many medical professionals feel like ... Read more
Part B Payments:
Are You Ready For Medicare Payment Reform?
Be prepared to innovate and develop new models of health care delivery. Watch out for ... Read more
Are You Ready For Medicare Payment Reform?
Be prepared to innovate and develop new models of health care delivery. Watch out for ... Read more
Modifiers:
Master Modifier X{EPSU} With These Examples
Choosing an alternative to modifier 59 is now easier. While the Centers for Medicare &... Read more
Master Modifier X{EPSU} With These Examples
Choosing an alternative to modifier 59 is now easier. While the Centers for Medicare &... Read more
Preventive Counseling:
Don't Give Away Obesity Counseling for Free
Tip: Count both individual and group counseling services provided to the patient. When... Read more
Don't Give Away Obesity Counseling for Free
Tip: Count both individual and group counseling services provided to the patient. When... Read more
Part B Documentation:
Keep Your Records as Airtight as Possible
Are you at risk for making this type of error? Vague descriptions can poke holes in yo... Read more
Keep Your Records as Airtight as Possible
Are you at risk for making this type of error? Vague descriptions can poke holes in yo... Read more
Home Health Face-To-Face:
F2F Puts HHAs' Payment At Stake
New form may reduce error rate. Home health agencies are still struggling with face-to... Read more
F2F Puts HHAs' Payment At Stake
New form may reduce error rate. Home health agencies are still struggling with face-to... Read more
Face-To-Face:
Nail Down F2F Compliance Or Expect A Reimbursement Hit
Sky high denials due to inadequate F2F documentation sound a wake-up call. While many ... Read more
Nail Down F2F Compliance Or Expect A Reimbursement Hit
Sky high denials due to inadequate F2F documentation sound a wake-up call. While many ... Read more
Industry Notes:
Opting Out? Treat All Medicare Patients Equally, CMS Says
If the thought of opting out of Medicare piques your interest, you might be in need of a... Read more
Opting Out? Treat All Medicare Patients Equally, CMS Says
If the thought of opting out of Medicare piques your interest, you might be in need of a... Read more
Quality Initiatives:
Buckle Up for a Tricky Reimbursement Ride With Value-Based Payment Modifier
Your payments could see a -6% impact if you aren’t paying attention. If you thou... Read more
Buckle Up for a Tricky Reimbursement Ride With Value-Based Payment Modifier
Your payments could see a -6% impact if you aren’t paying attention. If you thou... Read more
Compliance:
Avoid These Costly CERT Errors
Be warned: You could be forced to send your MAC a refund. The Centers for Medicare &am... Read more
Avoid These Costly CERT Errors
Be warned: You could be forced to send your MAC a refund. The Centers for Medicare &am... Read more
Compliance:
Follow This Compliance Director's Advice
Keep the following quick tips in mind to build an airtight compliance plan which can hel... Read more
Follow This Compliance Director's Advice
Keep the following quick tips in mind to build an airtight compliance plan which can hel... Read more
Modifiers:
Dearth Of Information Could Lead To Denials
Use new X{EPSU} modifiers with caution. The Centers for Medicare & Medicaid Servic... Read more
Dearth Of Information Could Lead To Denials
Use new X{EPSU} modifiers with caution. The Centers for Medicare & Medicaid Servic... Read more
Industry Notes:
CMS: No Extensions on ADR Requests
When you get a documentation request from your MAC or another Medicare entity (such as a... Read more
CMS: No Extensions on ADR Requests
When you get a documentation request from your MAC or another Medicare entity (such as a... Read more
Reimbursement:
Expect Some Hiccups In Claim Clearance
Conversion factor for 2015 already changed. The Centers for Medicare & Medicaid Se... Read more
Expect Some Hiccups In Claim Clearance
Conversion factor for 2015 already changed. The Centers for Medicare & Medicaid Se... Read more
Compliance:
Successfully Navigate the Minefield of Specialist Payment Arrangements
Keep your claims clean and compliant. If you bill for a service and pay part of the co... Read more
Successfully Navigate the Minefield of Specialist Payment Arrangements
Keep your claims clean and compliant. If you bill for a service and pay part of the co... Read more
Reimbursement:
Let Not the Lure of Lucre Influence Your Decision
Appropriateness of one day stays under federal scrutiny. Are you admitting patients wh... Read more
Let Not the Lure of Lucre Influence Your Decision
Appropriateness of one day stays under federal scrutiny. Are you admitting patients wh... Read more
OIG Hot List:
Misuse of Modifier AA Could Land You In Hot Water
Big Brother — OIG — is watching. The HHS Office of Inspector General (OIG)... Read more
Misuse of Modifier AA Could Land You In Hot Water
Big Brother — OIG — is watching. The HHS Office of Inspector General (OIG)... Read more
ICD-10 Preparedness:
Prepare For Impact On Your Systems
Office workflow changes, updating claims formatting only tip of the iceberg. With the ... Read more
Prepare For Impact On Your Systems
Office workflow changes, updating claims formatting only tip of the iceberg. With the ... Read more
Industry Notes:
MAC Outlines How to Handle Revalidation Requests
If you enrolled in Medicare before March 25, 2011, the Affordable Care Act requires you ... Read more
MAC Outlines How to Handle Revalidation Requests
If you enrolled in Medicare before March 25, 2011, the Affordable Care Act requires you ... Read more
Reimbursement:
Dig Into the Fine Details of Chronic Care Management Services
20 eligible patients could earn you up to $10,000 annually … if you follow the cr... Read more
Dig Into the Fine Details of Chronic Care Management Services
20 eligible patients could earn you up to $10,000 annually … if you follow the cr... Read more
Existing Scope of Chronic Care Management Services
The Centers for Medicare & Medicaid Services (CMS) did not make new requirements for... Read more
The Centers for Medicare & Medicaid Services (CMS) did not make new requirements for... Read more
Chronic Care Management:
Know Your CCM Practitioner Arsenal
Good news: General supervision a go for CCM services. When the Centers for Medicare &a... Read more
Know Your CCM Practitioner Arsenal
Good news: General supervision a go for CCM services. When the Centers for Medicare &a... Read more
Compliance:
Make Fewer Billing Mistakes, Report Your Services Ethically
Follow 7 tips from the OIG to build your compliance plan. Is building a strong complia... Read more
Make Fewer Billing Mistakes, Report Your Services Ethically
Follow 7 tips from the OIG to build your compliance plan. Is building a strong complia... Read more
ASCs:
Gear Up to File Cleaner Claims
Tip: Timeliness makes all the difference. Compliance requirements while coding and bil... Read more
Gear Up to File Cleaner Claims
Tip: Timeliness makes all the difference. Compliance requirements while coding and bil... Read more
Clip and Save:
Remember 9 Checkpoints for All Your ASC Claims
Keep this handy list as a reminder. Billing for ASC services can be quite different fr... Read more
Remember 9 Checkpoints for All Your ASC Claims
Keep this handy list as a reminder. Billing for ASC services can be quite different fr... Read more
Home Health Referrals:
Help Physicians Obtain Chronic Care Management Payment with These 6 Requirements
Don’t let Medicare’s red tape keep your physicians from claiming their chron... Read more
Help Physicians Obtain Chronic Care Management Payment with These 6 Requirements
Don’t let Medicare’s red tape keep your physicians from claiming their chron... Read more
Industry Notes:
This MAC Outlines How to Handle Revalidation Requests
If you enrolled in Medicare before March 25, 2011, the Affordable Care Act requires you ... Read more
This MAC Outlines How to Handle Revalidation Requests
If you enrolled in Medicare before March 25, 2011, the Affordable Care Act requires you ... Read more