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Medicare Compliance & Reimbursement

Reimbursement:
Save Thousands By Reporting Hospital Discharge Correctly
Bypass costly errors with these pointers. Experience may not pre-empt coding lapses wh... Read more
2013 Medicare Physician Fee Schedule:
Expect Telemedicine To Bring In Increased Revenues
Actual distribution of the federal funds to boost Medicaid rates left up to the individu... Read more
2013 Fee Schedule:
Get The Skinny On The Real Pay Impact Of New TCM Codes
No separate payment for face-to-face visit. While emergency physicians are not specifi... Read more
2013 AMA Symposium Update:
Don't Fret Over Far-Reaching Terminology Change
The most widespread changes throughout CPT® 2013 -- the switch to more inclusiv... Read more
Compliance:
Hospice-SNF Relationships On OIG Radar For 2013
Medicare coverage requirements not met in most cases of benes sent to nursing homes. T... Read more
Kickbacks:
Follow The Rules When Furnishing Bridge Services
Hospices: Get OIG approval prior to offering free services. Just because the OIG put i... Read more
Industry Notes
OIG Continues to Target Physicians The percentage of medical practices that were foun... Read more
Reader Question:
Medical Decision Making Is Not The Same As Medical Necessity
Question: What should be the overarching factor you use to select the overall level of s... Read more
Reader Question:
Unnecessary Lab Test Probably Won't Be Payable
Question: We have a patient who did not have a urinalysis done at his previous well visi... Read more
2013 Payment:
Practices Face 26.5 Percent Cut Unless Congress Steps In
Remember to read between the lines even for good news. The Centers for ... Read more
Home Health Prospective Payment System:
CMS Expects Home Care Spending To Decrease
Your case mix and wage adjustment increase will decide your reimbursement. ... Read more
ICD-10:
Don't Put Your ICD-10 Transition Plan On The Back Burner
A working budget should include every aspect of planning, including productivity, tr... Read more
ED Compliance:
Brush Up On Documentation For Simultaneous Critical Care Services
Medical necessity and time spent will dictate payment. If a patient is bro... Read more
Industry Notes
With Election Over, All Eyes Turn to Medicare Cuts With the election over, ... Read more
Compliance:
Enforcement Activities A Response To Uncovering Evidence Of Fraud, Say Reps
Fraud-fighters narrow focus to areas that will save the most money.If you're disconcerted ... Read more
Compliance:
New HHS Suspension Powers Can Create Havoc For Your Income
Gear up for more stringent anti fraud enforcement after the Oct. 4 crackdown.The Departmen... Read more
Home Health Coverage:
Lawsuit Settlement To Torpedo Improvement Criteria
Time to beef up documentation showing the need for skilled care in maintenance therapy and... Read more
Industry Notes
$100 Million Medicare Fraudster Pleads GuiltyDavit Mirzoyan, who pled guilty before United... Read more
Reader Question:
Carrier LCD Determines Whether to Expect Payment for J7325
Question: One of our Medicare patients receives knee injections for her arthritis. She's i... Read more
Reader Question:
Prescriptions Are Included in E/M Service
Question: My physician heard that there's a code we can report and be paid for just when h... Read more
Compliance:
Identical Documentation, Inappropriate E/M Payments On OIG's Radar
Watch out for improper modifier use and incident-to billing in 2013.The Health and Human S... Read more
Self-Audit Your Way to Successful Claims
Self-audits aren't only necessary if your practice has been scheduled for an OIG audit. Wh... Read more
Home Health Regulations:
Brace For More Monetary And Compliance Burdens
Surety bonds could close your doors if OIG implements this requirement ruthlessly.The Cent... Read more
Know Your Facts:
These Stats Keep You On Investigators' Radar
Number of HHA subjects investigated skyrocketed 125 percent in five years.Federal investig... Read more
Industry Notes:
Industry Notes:
One State Just Says 'No' to OIG RecoveryThe OIG wants New Mexico to recover $11 million fr... Read more
Reader Question:
Check Your Contracts for Specialized Lab Test Billing
Question: Our physician has been running some very specific tests (saliva, stool, heavy to... Read more
Reader Question:
Don't Get Too Creative When Counting HPI Elements
Question: Can you give me the total number of elements in the HPI example that follows:70 ... Read more
Reader Question:
Is Parking Lot Service Billable?
Question: How do I bill a service that took place in our parking lot? The mother of the pa... Read more
Preventive Care:
Try These CVD Behavior Therapy Claims Success Tips Straight From CMS
Make the most of the new preventive services coverage additions.Have you started filing cl... Read more
Audit Preparedness:
Prep For These Common Audits Your Practice Could Soon Face
Expert pointers offer insight on how to face the auditors.With multiple kinds of audits un... Read more
Home Health Regulations:
Home Health Agencies Deliver Blistering Comments On Proposed F2F Requirements
Proposed mandate creates more problems than it resolves, commenters say.Providers are skep... Read more
Industry Notes
Medicare Fraudsters Put On NoticeIn one of the biggest takedowns in Medicare history 91 in... Read more
Reader Question:
You Can Now Use Modifier PD
Question: Please explain to me when to use modifier PD. Does this apply to us when a patie... Read more
Reader Question:
Medicare Doesn't Expect Hospital and ER Doc Codes to Match
Question: Does Medicare require that the E/M CPT® codes submitted for payment b... Read more
Reader Question:
It's The Total Dosage That Counts For Prescription Strength OTC Medicines
Question: I am looking for assistance on this. I have a provider who has stated that if he... Read more
2013 Fee Schedule:
Heads up: Expect FP Medicare Pay Boost
CMS realizes importance of paying more attention to primary care. Family physicians and si... Read more
News You Can Use:
Pathologists And Labs: Brace for More Pay Cuts in 2013
Unless CMS makes changes in the final rule, this is what you can expect.The Medicare Physi... Read more
Home Health Reimbursement:
No Solution To Wage Index Problems On The Horizon
CMS action awaited to even the playing field for HHAs. Home health agencies are keeping th... Read more
Collections:
4 Strategies Help You Recoup for No Shows
Collect your lost reimbursement while remaining compliant.When missed appointments happen,... Read more
Industry Notes:
Obama Administration Launches Partnership To Fight Healthcare Fraud
The Obama administration obviously believes an ounce of prevention is worth a pound of cur... Read more
Denial Management:
Not So Fast: Put the Brakes on E Codes as Primary Dx
New CMS directive says claims with E codes as primary diagnoses unprocessable.If you're su... Read more
Legislation:
Expect Some Short Term 'Preventive Care' Bonuses
Look ahead to doctor-patient relationship and billing changes.Ever since the Supreme Court... Read more
Home Health Compliance:
Are You Prepared To Cough Up $100K?
Failure to cross-check OIG exclusion list can hit you where it hurts the most -- in y... Read more
Industry Notes:
CMS Issues New 'Centralized Flu' NPP Specialty Code
If you were beginning to think that CMS had a specialty code for almost everything, here's... Read more
Reader Question:
How Long Must The Assistant Be Present In Order To Bill For The Service?
Question: When we have an assistant surgeon from our practice scheduled to assist the prim... Read more
ICD-10:
It's Official: Gear Up for 2014 ICD-10 Implementation
CMS confirms pushback.The long awaited word is out: You have to go live with ICD-10 Oct. 1... Read more
ACA Implementation:
Cut Through the ACA Fog: Keep These Areas On Your Radar
Watch out for possible reductions in reimbursement.With many issues of the Affordable Care... Read more
Reimbursement:
Eradicate Denials Caused By These Obsolete Billing Practices
Stay abreast of changes and secure a healthy bottom line.You want to avoid these three mis... Read more
Claim Errors:
Avoid Making These Common E/M Errors To Keep Your Reimbursement Intact
CMS reveals shocking 9.2 percent error rate in latest CERT results.The latest Comprehensiv... Read more
Compliance:
Navigate The Insider Deals Minefield To Sidestep Impropriety Charges
Take a lesson from this non-profit hospice.You need to go the extra mile to keep your vend... Read more
Industry Notes:
Women Can Access Even More Life-Saving Preventive Care Free Of Charge
Women can look forward to a healthier life, thanks to with new rules in the health care la... Read more
Reader Question:
Do You Really Want To Go Nuclear With Competitors' Kickbacks?
Use these steps below to weigh your options before responding.Question: In this day and ag... Read more
Coding Errors:
CMS Unveils Error Rates: Chiropractic And E/M Services Top The List
Ob-gyns, emergency room visits and initial hospital visits need to be concerned. Chiropra... Read more
Compliance:
Beat Auditors to the Punch: Use Self-Audits to Correct Your Documentation Glitches
Top tip: Medical necessity should drive your practice's claims. Conducting regular self-a... Read more
Home Health Enforcement:
Watch Out: These New Alternative Sanctions Could Put You Out Of Business
Surveyors get more tools. If your home health agency isn't carefully policing compliance ... Read more
Check Out The 5 New Alternative Sanctions
As always, the Medicare program will retain its ability to terminate home health agencies... Read more
Industry Notes:
CMS to Start Denying Claims That Don't Meet Ordering/Referring Edits 'Soon'
If a new CMS news release is any indication, the agency might soon follow through on its ... Read more
Compliance:
Prep For ACA With An Airtight Compliance Plan
Enlist expert help to establish a compliance plan for both Medicare and Medicaid. The... Read more
5 Steps To Ensure Compliance
There's no better job security for billing staff than being able to prove you are current ... Read more
Denial Management:
Sidestep Billing Headaches By Checking Practitioner Specialty Enrollment
Dodge the 'no-pay zone' -- inspect your patients' insurance cards. If you MAC rejects... Read more
Billing:
Improve Your Payment Odds With This ABN-Style Waiver
Avoid problems caused by unexpected bills.When you know that a MAC won't pay for certain s... Read more
Collections:
Crack The Copay Waiver Compliance Riddle With These Savvy Pointers
Remember to meet the necessary criteria for waiver and back it with documentation.You coul... Read more
Industry Notes:
CMS Clarifies Which Staff Members Can Perform AWV, WTM Exam
Ever since CMS began to pay for annual wellness visits (AWVs) and Welcome-to-Medicare (WTM... Read more
Part B Payment:
Take A Sneak Peek At The Proposed 2013 Fee Schedule
Primary care physicians, internal medicine practitioners have cause to rejoice.Next year's... Read more
Regulations:
Need ACA Clarity? Dispel Confusion With These Facts
Good News: Tell patients that they are entitled to a government rebate on Rx costs if they... Read more
Payer Processes:
Clear Up Collection Uncertainty With These FAQs
Ethically maximize your practice's reimbursement and reduce the costs of administering cla... Read more
Home Health and Hospice:
Banish Medical Necessity Denials With These Expert Pointers
Stop risking reimbursement by understanding coverage rules and properly training and super... Read more
Industry Notes:
1.2 Million People To Come Under Medicare Services
As of July 1, 89 new Accountable Care Organizations (ACOs) have started serving 1.2 millio... Read more
Audits:
CMS Update: Your Old Records Now Fair Game for MAC Claims Review
CMS nixes the one-year lookback period effective June 26.Part B MACs now have more flexibi... Read more
ICD-10:
Check Out What The Experts Have To Say About ICD-10's Benefits
3 hidden advantages make the learning curve worthwhile.If the sheer volume of new diagnosi... Read more
Compliance:
Don't Let Your Financial Arrangements Get You Into Sticky Situations
Keep an eye open for these compliance minefields.That the OIG means business is clear from... Read more
Billing:
Brush Up On Your POS 22 Rules To Keep Your Practice In The Clear
Starting in October you need to focus on where the face-to-face service was performed.If y... Read more
Enforcement:
OIG Bags $1.2 Billion For Medicare in Massive 6-Month Dragnet
There may be more criminal actions and exclusions on the horizon.Medical practices across ... Read more
Home Health Reimbursement:
Pull The Plug On These Common Working File Errors
Inaccuracies in the CWF jeopardize your Medicare pay.Home health or hospice providers who ... Read more
Medical Review:
Denial Rates For Long-Stay Patients On The Rise
Ensure that your documentation for patients living longer than the six-month prognosis sta... Read more
Industry Notes:
AMA 'Evaluating ICD-11' As ICD-9 Alternative
The American Medical Association (AMA) has made no secret of the fact that it is less th... Read more
Reader Question:
Shifting Between MD Supervision and Direction
Question: Four certified registered nurse anesthetists (CRNAs) from our group were working... Read more
Reader Question:
Know CRNA Choices for Colonoscopy
Question: Is a certified registered nurse anesthetist (CRNA) allowed to bill Medicare for ... Read more
Compliance:
Billing Prolonged Services? Keep a Close Eye On The Clock
Avoid making some of the biggest errors that MACs see.A lax approach to documenting time f... Read more
Claim Denials:
Add This Top Tool To Your Toolkit and Avoid Claims Rejections
Hint: Verify patient eligibility.One handy checklist could be just what you need to keep y... Read more
Hospital E/M Billing:
Get The Skinny On The Intricacies Of Inpatient E/M Services
Let our experts help you avoid potential OIG scrutiny.Selecting outpatient E/M codes (9920... Read more
Reimbursement:
Don't Bill CRNA Locum Tenens With Q6
Use these Q&As as a reference if one of your physicians goes on scheduled leave. There... Read more
Industry Notes:
OIG Audit Finds Only 15 Percent of E/Ms With Eye Injections Were Properly Billed
Tacking an E/M code onto your eye injections as a standard billing strategy? Not so fast. ... Read more
ICD-10:
Mixed Reactions From The Medical Community on ICD-10 Delay
Implementation could be pushed back to 2015 if the AMA has its way.Whether you submitted c... Read more
Part B Mythbuster:
Integrate Mid-Level Providers to Help With the Tough Cases
Don't deny yourself additional income by only using non-physician practitioners for the si... Read more
Compliance:
OIG to Send CMS Names of 1,700 Docs Who Overbilled High-Level E/M Codes
Frequency of reporting 99214 and 99215 increased 17 percent over 9-year period.If you exam... Read more
Global Surgery Package Pay for Cardiovascular, Musculoskeletal Surgeons Could Be Slashed
Latest OIG reports indicate that these specialists aren't performing all included E/Ms.You... Read more
E/M Billing:
OIG Targets Facilities That Bill E/Ms Which Should Have Been Included in Procedures
Save yourself from this potential minefield with these expert tips.If you see a patient in... Read more
CMS Coverage:
Check New Code for Sexually-Transmitted Disease Counseling
Know what constitutes 'high risk' patients in CMS's view.You may have heard that Medicare ... Read more
Medicare:
Follow 2 Key Takeaways for MSP Claims Success
For even more resources, check out MLN Matters SE1217.When Part B practices perform self-a... Read more
Industry Note:
New CMS Proposal Would Boost Primary Care Medicaid Pay
As most practices remember, the Affordable Care Act, which was signed into law in 2010, of... Read more
Reader Question:
Review State Laws for Billing Time Frame
Question: Is there a time limit on when you can bill a patient for their balance due after... Read more
Billing Corner:
Overcome Primary vs. Secondary Payer Woes with Answers to Your FAQs
Start with the basics and then move on to learning the intricacies. When a patient is cov... Read more
Follow These CMS Rules for Submitting Medicare Secondary Payer Claims
Hint: Copy all beneficiary insurance cards, not just the Medicare one. When Part B practi... Read more
Medicare Funding:
Medicare Projected to Go Broke in 2024, Trustees' Report Says
Part A is poised to run out of money -- and although safe for now, Part B could be a... Read more
Compliance:
Avoid Five Common Compliance Landmines
Follow these strategies to ensure you stay on the right side of the law. Every medical pr... Read more
Reimbursement:
Don't Miss This Increase in the Medicare ACF for All 2012 Claims
Re-analyze your claims for Q1 services that deserve higher pay. You have reason to celebr... Read more
Rural Health:
Follow the Updated Definition of "Privileged" Provider for Ordering Hospital Services
CMS clarifies Transmittal 72 regarding rehab, respiratory care referrals. If you work in ... Read more
Home Health Certification:
Beware F2F Documentation Signed By Residents
CMS answers about face-to-face requirements raise more questions. That face-to-face docum... Read more
Industry Note:
CMS Debuts New 'Date of Death' Code
CMS Debuts New 'Date of Death' Code When a patient passes away while in your physician's ... Read more
Reader Question:
How Should You Bill Medicare?
Question: We are participating with Medicare. We bill and submit claims to Trailblazer (J... Read more
Reader Question:
Ensure That Physician Performs Initial Nursing Facility Visit
Question: I am receiving denial C0-170 (Payment is denied when preformed/billed by this t... Read more
Compliance Evaluation:
Evaluate Your Billing Procedures With Internal Audits, Before an Outside Auditor Does
Starting with a baseline audit will set your practice up for success. Would you pass an a... Read more
Billing:
CMS Clarifies Rules for Submitting Medicare Secondary Payer Claims
Hint: Copy all beneficiary insurance cards, not just the Medicare one. When Part B practi... Read more
Revenue Booster:
Capture All Your Work When Treating Kids Who Have Special Healthcare Needs
Diabetes, ADD, and asthma aren't always an E/M-only visit: Collect for your other service... Read more
Compliance:
Will Lax Home Health OASIS Submissions Earn Your Agency a 2 Percent Penalty?
New OIG report questions home health data collection and reporting practices. If you have... Read more
Industry Notes:
Industry Notes:
NJ Doctor Sentenced for Billing 900 Endoscopies on One Patient Wondering whether insurers... Read more
Reader Question:
Double Check Copay Early to Save Time, Money
Question: A patient came to our office with the same insurance card she's had for years. ... Read more
ICD-10 Update:
CMS Proposes One-Year Delay for ICD-10
Don't count on the delay quite yet, coding expert warns. Health providers and practices h... Read more
Compliance:
Let Audits Help You Capture Missed Charges and Improve Compliance
First determine if a prospective or retrospective audit is best. Medical offices that don... Read more
Billing:
CMS to Institute Payment Edits for E/M Services During Global Periods
When RACs find massive errors, MACs listen. Starting this July, modifiers will be more im... Read more
News You Can Use:
You Can Stop Worrying About a 27 Percent Medicare Cut -- Until the End of the Year At Least
10-month delay will only push payment formula problems to 2013. If your practice has been... Read more
Billing Errors:
One Medicaid Payer Reveals Its Top 5 Errors -- Know How You Can Avoid Making the Same Mistakes
Coding errors once again top the list of the most common mistakes. Did you catch a miscod... Read more
Fraud & Abuse:
78 HHAs Put On Suspension At Once As Part Of Fraud Bust
Be careful about which docs certify your patients for home care. It's not just home care ... Read more
Industry Notes
CMS Offers Medicare Billing Certification Are you a Medicare billing pro? CMS now offers ... Read more
Reader Question:
Review Contracts before Directly Billing the Patient
Question: Can you please help us understand if it is better to bill the patient for DME i... Read more
Audits:
RACs Are Now Checking Your Modifier 25, Injection Claims
Plus: Contractors are also auditing place of service, bilateral services, and consolidate... Read more
Compliance:
Your Staffers Will Be Less Likely to Whistle If You Follow These Tips
A robust reporting mechanism is your best defense against a whistleblower suit. If your c... Read more
Follow OIG Compliance Plan Guidance Step By Step
Missing an element could set you up for a costly lawsuit, or worse. Don't get caught in t... Read more
Billing Primer:
Considering Going Out of Network? Follow These 3 Tips to Pave the Road to Success
Be honest with your patients to ensure a smooth transition. More and more providers are q... Read more
Home Health Reimbursement:
Use This ADR Tool To Hang Onto Reimbursement That's Yours
Providers pass on OIG's second chance to submit medical records. You have most likely hea... Read more
Industry Notes:
CMS Rolls Out New Medicare Advantage Auditing Plan
CMS has been auditing Medicare Advantage (MA) plans since 2008, so practices may not be s... Read more
Reader Question:
Here's When To Treat Established Patients As New
Question: We saw a patient over a year ago for a thyroidectomy, and now the patient retur... Read more
Audits:
This MAC Shares the Dirt on 4 Common Audit Types
Chinese restaurant menu didn't cut it as documentation for one hospital. Does it sometime... Read more
Money Matters:
Improve Your Practice's Bottom Line With 12 Easy-to-Implement Strategies
The bonus: You'll help meet your patients' changing payment needs, too. Every dollar coun... Read more
Claims Errors:
This MAC Denied Over 1,200 Claims for Services Administered to Deceased Patients
Avoid these top ten Medicare errors to avoid revenue drains. What's the top tool in your ... Read more
D.O. Billing:
E/M With Osteopathic Manipulation May Be Billable -- If You Know the Rules
Avoid appending modifier 25 to all cases -- instead, focus on medical necessity in t... Read more
Annual Wellness Visits:
5 Strategies Help You Deal With Patients Who Refuse to Complete HRA Form
If necessary, show patients the regulations in writing. You pored over creating a simple-... Read more
Industry Notes:
If You Aren't Ready For 5010 Yet, It's Time To Kick Your Efforts Into High Gear
The April 1 enforcement deadline for using 5010 claim standards is fast approaching. "To ... Read more
ICD-10:
ICD-10 Date Will Be Postponed, HHS Confirms
Delay could offer practices additional time to prepare for new diagnosis coding system. I... Read more
Part B Payment:
Congress Reaches Tentative Deal to Avert 27 Percent Medicare Cut
However, 10 month delay will only push payment formula problems to 2013. If you were biti... Read more
Part B Update:
Despite CPT® Revision, Medicare Won't Update 'New Patient' E/M Rules for 2012
Plus: Claims reprocessing has completed, so make sure your claims have been corrected.As ... Read more
Compliance:
You May Soon Have Only 60 Days to Return Medicare Overpayments -- Or You'll Face Penalties
New CMS proposal would impact all self-identified overpayments that your contractor sends... Read more
Billing:
3 Steps Can Correct Your Cash Flow Woes
These simple strategies can improve your bottom line. If your accounts receivables (A/R) ... Read more
Industry Notes:
OIG Offered Practices Second Chance to Submit Required Records, But Most Didn't Take It
You have most likely heard the phrase "if it wasn't documented, it wasn't done" so many t... Read more
Reader Question:
Does Ability to Bill the Patient Expire?
Question: Is there a time limit on when you can bill a patient for their balance due afte... Read more
Compliance:
OIG Urges Physicians to Use 'Heightened Security' When Reassigning Medicare Payments
You could be liable for false claims submitted by those entities. Reassigning your Medica... Read more
Part B Payment:
Congress in Apparent Deadlock Over Medicare Cuts, With 27 Percent Cut Looming
Effective March 1, you'll watch Medicare payments drop unless legislators come to an agre... Read more
Part B Revenue Booster:
'Follow-Up' Is Not A Sufficient Chief Complaint
Improve your E/M payment odds with these 5 quick tips Most practices report E/M codes eve... Read more
Compliance:
Find Out What the Stark 'Physician Self-Referral Law' Actually Covers
Need an exception? They only apply in specific scenarios. If anything in the healthcare i... Read more
2012 Physician Fee Schedule:
Good News: Expect More Flu Vaccine Reimbursement in 2012
Pay for 3 of your most common vaccine codes will rise. Your physician should be smiling... Read more
Home Health Care Plan Oversight:
Stop Giving Away Your CPO Services for Free
But ensure that a face-to-face visit took place before you bill. Don't let carriers under... Read more
Industry Notes:
Medicare Offers Handy Tool to Ease Preventive Service Billing Burden
Between the IPPE, AWV, AAA, and beyond, you're probably confused at the alphabet soup of ... Read more
Part B Revenue Booster:
Document Counseling and Coexisting Conditions to Justify E/M Level
Show physicians how to thoroughly document all diagnoses addressed to ensure complete doc... Read more
Incident-to Billing:
Shore Up You Incident-to Claims or Face OIG Scrutiny This Year
Ensure your visit meets 4 criteria before filing an incident-to claim. If you don't know ... Read more
Home Health Compliance:
Don't Jump The Gun On Companionship Exemption Planning
How much risk are you willing to take on? The Department of Labor's dramatic proposal to ... Read more
Hospice Compliance:
Make Sure These Documents Are In Your Nursing Home Patients' Files
Plus: Help nursing homes use the MDS to identify residents who need hospice services. Fed... Read more
Industry Notes:
$6 Million Question for Denver Hospital -- 'Observation,' 'Inpatient,' Or 'Outpatient'?
When your physician admits a patient to the hospital, your coding work isn't done --... Read more
Reader Question:
Avoid Automatically Writing Off Secondary Insurance Deductibles
Question: We have many patients with secondary insurance, some of which have deductibles ... Read more
Reader Question:
Many Insurers Still Accept Consult Codes
Question: An established patient who was about to undergo a tonsillectomy presented to ou... Read more
Part B Payment:
Congress Votes to Boost Conversion Factor Through February 29
At nearly the last minute, lawmakers ensure that you won't lose 27 percent. Although the ... Read more
Payer Participation:
4 Tips Help You Successfully Collect for Services When Your Practice Does Not Participate
Hint: Collecting early is often the key. As payer contracts get more and more complicated... Read more
Compliance:
OIG to Focus on Medicaid Overpayments, CCI Effectiveness in 2012
Watch out: Medicaid claims may face greater scrutiny in the coming year. Are you hanging ... Read more
Compliance:
Know When Your Patients Qualify For Home Care -- And When They Don't
Use this checklist from one HHH MAC to guide your eligibility assessments. Medical review... Read more
Industry Notes:
CMS Outlines New ICD-10 Codes for 2012
You may not be familiar with the ICD-10 code set yet, but it continues to grow anyway. CM... Read more
Reader Question:
Get to Know Pecking Order for CPT® Codes
Question: I know that as a general rule the highest RVU has a higher billed amount and th... Read more
Medicare Errors:
Providers Underbilled More Than $1 Billion to Medicare in 2010
CERT results reveal $34.3 billion in improper Medicare payments -- $1.1 billion of w... Read more
Part B Revenue Booster:
Collect for New Medicare Preventive Services With These 'G' Code Additions
Services became payable within the last two months, so you can begin billing MACs for the... Read more
Documentation:
Make Audit-Proof Record Corrections With These 5 Tips
Documentation clarifications can be a big help -- if you use them wisely. With the p... Read more
Documentation Red Flags:
Know When A Clarification Hurts Instead of Helps
Documentation Red Flags: Know When A Clarification Hurts Instead of Helps "With regard to... Read more
Home Health Billing:
Keep Your Billing On Track With These Crucial Benchmarks
You should run this vital billing report weekly. Home health agencies that fail to keep t... Read more
Compliance:
OIG Ramps up HHA Oversight for 2012
OIG work plan adds 5 new HHA topics to 4 existing ones. Monitoring home health agencies w... Read more
Industry Notes:
CMS Releases Updated, Aggressive 5010 Timeline
CMS offered an early holiday gift to medical practices with the Nov. 17 announcement that... Read more
Reader Question:
67912 Includes Supply Charge
Question: How would I code for insertion of gold eyelid weights to correct lagophthalmos?... Read more
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