Hospitals Saw Substantial Underbilling for Medicare Telestroke Services

Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial underbilling from hospitals with…

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Top 3 Concerns with the 2021 Medicare Physician Fee Schedule Rule

Provider groups are concerned that some proposals in the Medicare Physician Fee Schedule rule for 2021 would exacerbate the financial challenges physicians are already facing during the COVID-19 pandemic, including…

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Medicare Audits: Who Bears the Burden in Your State?

Where the burden lies could make a difference when it comes to the RACs. In a legal lawsuit, one party is initially presumed to be correct and gets the benefit…

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Medicare can save millions on lab tests by creating panel codes

Clinical diagnostic laboratory tests range from routine chemical measurements like blood glucose or sodium to complex examinations for cancer, infectious diseases, or rare inherited disorders. The information they provide is…

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Louisiana Leads The Nation In Medicare Overbilling

Louisiana posted the highest rate of Medicare being overbilled for services in the nation in 2015, with providers charging an estimated $1.25 billion more than they should have, according to…

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Medicare Coding Errors to Avoid: Add-on, Place of Service, and Modifiers

Medicare audits have revealed recurring errors in billing with add-on and place-of-service codes. In addition, Medicare continues to receive claims that appear to be duplicate because they lack an appropriate modifier. Here are some guidelines for correct billing.

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An Out-of-Control Medicare Audit

What happened to Eastern Carolina internal Medicine (ECIM) in Pollocksville, North Carolina is a provider’s nightmare about government oversight run amok. A Medicare audit began as a medical records request.…

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Medicare Payments Exposed

For the first time, the federal Centers for Medicare and Medicaid Services (CMS) has made public a database showing what it pays out to individual physicians. In a press release,…

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