Discharge Planning Conditions of Participation guidance from CMS is being seen as unhelpful. As hospitals prepare to implement the Centers for Medicare & Medicaid Services (CMS) Discharge Planning Conditions of…
CMS and the Department of Veterans Affairs (VA) recently announced a new data sharing initiative in which the departments will share provider enrollment data to prevent healthcare fraud, waste, and…
The owner of a transportation company has pleaded guilty to fraudulently billing millions in false claims to the state’s Medicaid Program (MassHealth), Attorney General Maura Healey announced today. Michael Davini,…
ICD10monitor and Talk Ten Tuesdays are launching a new series today, which will continue through November, focusing on the need for early preparation for the new ICD-11 code set that…
CMS clearly is honing-in on reducing administrative burden as changes go into effect. On Friday, Nov. 1, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee…
There are 2,115 additions to the third quarter Medicare National Correct Coding Initiative (NCCI or CCI) practitioner edits that became effective July 1, 2019. The good news is that the…
Medical billing reports are important in evaluating the efficiency of your practice. Thus, reports should show the performance of your organization in full details. This will greatly help in improving…
A new HCPCS Level II code lets you report the SinuvaTM implant for nasal polyps, but coding for placement may vary based on the encounter. Medicare Administrative Contractor (MAC) National…
Agencies continue their investigation into the underlying cause of electronic cigarette/vaping-associated lung injury. The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) continue to…
Becker's Hospital Review reported on the following payment model updates from CMS or HHS in October: 1. CMS is now taking applications for kidney care payment models. Participation in the…
Too little attention is paid to documentation, coding, and billing in many medical practices. For patients, documentation simply means that your doctor is providing an account of your visit in…
Providers should keep in mind that such policies aren’t binding – but can offer valuable direction. Imagine your Medicare Administrative Contractor (MAC) had a policy detailing their coverage of records…
Securing successful contracts with payers is becoming increasingly important for ASCs as they move toward negotiating value-based contracts. Lisa Davis, administrator at The Center for Minimally Invasive Spine in Munster,…
In light of new value-based care models and creative partnerships between providers, CMS is ditching its pay-and-chase approach to reducing Medicare fraud, waste, and abuse and implementing a new five-pillar…
In an effort to help broaden the ways in which social determinants of health can inform clinical decision making, eHealth Initiative & Foundation has recently released some new tools to…
Most healthcare organizations partner with physician services groups for niche coverage. While outsourced medical services are available across all specialties, common areas for external physician support include anesthesia, radiology, wound…