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…
Health plans and other stakeholders are convinced that the use of ICD-10 coding can greatly launch the uniform capture of data related to social determinants of health and improve health…
More than 700 pages of text make up proposed changes to the federal Stark and anti-kickback statutes. On Wednesday, Oct. 9, federal healthcare officials announced two new proposed rules. While…
I shouldn’t be surprised. I have been reviewing denials by insurance companies since the late 1980s. I’ve seen the same things over and over again, such as slow pay, delayed…
Medical coders are typically behind the scenes of patient care, analyzing records, selecting codes for billing, and managing patient data. But to Jannifer Owens, a revenue cycle expert with over…
PR’s “Coding Corner” focuses on coding, compliance, and documentation issues relating specifically to physician billing. This month’s tip comes from Deborah Marsh, senior content specialist for AAPC, a training and credentialing…
A “bold proposal” to reduce the documentation burden on physicians was released as part of CMS’s 2019 proposed Medicare Physician Fee Schedule (PFS). This seemed to have begun as an…
AI presents an entirely new landscape for defense against audits. The Trump administration has launched a program to employ artificial intelligence (AI) in Medicare audits. Use of AI will make…
Patients come to your office looking for answers to their pain or lack of function. It’s critical that a doctor doesn’t do what one of my clients admitted to recently…“X-raying…
A change in government payment policy for dermatologists and other physicians in selecting office coding and billing for evaluation and management (E/M) is scheduled to begin January 2021. “The Centers…
The time to strengthen hospital compliance programs through claim validation is now. According to healthcare finance and information management leaders surveyed by HIMSS Media, clinical documentation and coding were the…