Medical practices receive many communications from payers that aren’t indicative of a problem. A payer needs more information to process a claim. Or, … [Read more...]
2018 CERT Analysis
CMS has not released a full Comprehensive Error Rate Testing (CERT) report since 2016. But, the 2018 supplemental report provides ample information … [Read more...]
Billing physician services for hospice patients | Cheat sheet
Medical practices find the hospice modifiers confusing, and confusion leads to denials and payment delays. Use the decision trees below to help you … [Read more...]
Billing medical practice services for patients on hospice
Overview of hospice care Medicare beneficiaries who have a terminal illness with a life expectancy of six months or less can elect to have their … [Read more...]
Compliance issues in ICD-10 coding for risk based contracts and HCCs
Everyone loves to read the general guidelines at the front of the ICD-10 book, right? No? Well, here’s an excerpt. “Code all documented conditions, … [Read more...]
A Rose by Any Other Name | EMR and Compliance
The blog post below, written in 2017, discusses the issue of copying and pasting in electronic health records. Since then, CMS has changed its stance … [Read more...]
7 sure fire ways to owe the government $4 million in fines and repayments | Coding Compliance
Most practices aren’t looking to pay the government any money in fines and repayment because of coding errors. Two recent OIG settlements described … [Read more...]
Medicare Rules for Incident-to Billing and Shared Services | Webinar
Incident-to services appear on the OIG Work Plan frequently. The stakes are high for the practice in terms of revenue and compliance. Ask around the … [Read more...]
I Want to See that in Writing | Medical Coding Source Citations
Lunch and Learn Coders are often asked to prove a coding rule to physicians and managers. Coding rules change, reimbursement rules change and … [Read more...]
This practice paid Medicare $4.48 million
Do you sign up for email lists and then wonder why you did it? We all do, don’t we? But, one email I always read is the one from the Department of … [Read more...]
So Your Payer Has Requested Records: Billing high level services
Documentation is key when billing high level services. What do clinicians need to know? What role do education and internal audits play? This short … [Read more...]
Medical Billing: Avoiding the Three Deadly Sins of Compliance
What is the real risk of compliance audit from commercial payers or from Medicare? This short video addresses three specific areas of risk and offers … [Read more...]
Skype ≠ Telemedicine
I got a call from a vendor trying to develop a video conferencing product for a physician to use to talk to a patient who is at home. He said “I’m … [Read more...]
Risky business, or tempest in a teapot: Are you an audit target?
Some days, it appears we compliance and coding folks are like the boy who cried wolf. We see shadows around every corner. We emulate Captain Kirk, … [Read more...]
No Chart Left Behind: Deadline to Complete Medical Records
Years ago, I worked with a physician who was chronically behind in dictating his notes. The charts were crammed into boxes by date, lining the walls … [Read more...]