When commenting on the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule for calendar year (CY) 2023, the American Hospital Association (AHA)…
CMS has specific guidelines when defining “incident to” and shared visits. Recently, I was working with a client to help them understand “incident to” billing. We were discussing a situation…
The rise of telehealth during the COVID-19 pandemic pushed up the timetable on telehealth education for medical schools and residency programs. But the relative lack of training using this newer…
Time for CDI checkup. Clinical Documentation Integrity (CDI) programs may be exposing hospitals to unnecessary, costly compliance risks and financial exposure by virtue of their very nature and purpose. When…
Doctors can use a government database to compare their practice patterns to others across the nation, says a former Wall Street trader turned physician. The database, maintained by the Centers…
In 2021, the Centers for Medicare & Medicaid Services (CMS) issued guidance to emphasize the importance of social, economic, and environmental factors that can affect the health outcomes of disadvantaged…
A new survey of physicians finds they are still facing burdens meeting prior authorization requirements despite a voluntary 2018 agreement among payer groups to reform the practice. The survey was…
The rising cost of healthcare in the United States has left consumers feeling lost and overwhelmed. High deductible healthcare plans, co-pays, and out-of-pocket medical expenses have all contributed the emergence…
June 30, 2022 William N. Parham, III, DirectorPaperwork Reduction StaffOffice of Strategic Operations and Regulatory AffairsCenters for Medicare & Medicaid Services7500 Security BoulevardBaltimore, Maryland 21244 Re: Provider Complaints Submission Process…
New codes and guidelines become effective Oct. 1, 2023. The Centers for Medicare & Medicaid Services (CMS) published the ICD-10-PCS codes and guidelines for the 2023 fiscal year on May…
Are you using something other than two-midnight? Here’s why you shouldn’t be. Is there the possibility that your utilization management team and physician advisors are applying InterQual, MCG, or any…
How to stay compliant in behavioral health screenings. Behavioral health screenings aim to detect mental health symptoms in many seemingly healthy people. This can be done in various ways, including…
Medical billing and coding is one of the hottest medical professions in great demand with a great deal of job opportunities and rooms for promotion. Promotion will come with increment…
Some flareups may lead to readmissions within 30 days. We can all agree that we want to fully treat our patients’ acute problems that require inpatient hospitalization, allowing them a…
Choosing a proper office visit code can become confusing unless one understands the rules separating preventive medicine and evaluation and management (E&M) coding. Problem-oriented E&M services, office, and other outpatient…
You might know that medical billing is a challenging process. That’s the reason why many people make several mistakes in this case. If you have the same problem, you can…