Practice Management Alert
Audits, Part 1:
Focus on Scope to Make Your Audit Worth the Effort
Determining which resources you need to allocate will save time and money. You know audi... Read more
Focus on Scope to Make Your Audit Worth the Effort
Determining which resources you need to allocate will save time and money. You know audi... Read more
Policy Pinpoint:
Don’t Blame HIPAA When It Comes to Vaccination Status and Personal Rights
Use this policy primer when explaining privacy rights surrounding vaccination to patients... Read more
Don’t Blame HIPAA When It Comes to Vaccination Status and Personal Rights
Use this policy primer when explaining privacy rights surrounding vaccination to patients... Read more
Billing:
Don’t Miss Additional Updates to Surprise Billing Rules
Prepare your patient notification strategies now. 2021has brought several updates in fede... Read more
Don’t Miss Additional Updates to Surprise Billing Rules
Prepare your patient notification strategies now. 2021has brought several updates in fede... Read more
Reader Questions:
Can Payers Downcode My Claims Without Warning?
Question: A payer I work with consistently downcodes our claims and never gives us wa... Read more
Can Payers Downcode My Claims Without Warning?
Question: A payer I work with consistently downcodes our claims and never gives us wa... Read more
Reader Questions:
Know Your Responsibilities for Retaliation Complaints
Question: What do we do if an employee files a complaint against our organization with the... Read more
Know Your Responsibilities for Retaliation Complaints
Question: What do we do if an employee files a complaint against our organization with the... Read more
Reader Questions:
Include These 6 Things in a Special Report
Question: What do I need to include if I have to file a special report for a service? The... Read more
Include These 6 Things in a Special Report
Question: What do I need to include if I have to file a special report for a service? The... Read more
Best Practices:
Here’s How to Maximize Your Scheduling Process
Plus, teaching your providers to talk about their colleagues may pay off in a huge way. W... Read more
Here’s How to Maximize Your Scheduling Process
Plus, teaching your providers to talk about their colleagues may pay off in a huge way. W... Read more
E/M:
See Through the Haze of MDM Confusion
Hint: Listing all possible diagnoses can bolster evidence of MDM. 2021 brought many eval... Read more
See Through the Haze of MDM Confusion
Hint: Listing all possible diagnoses can bolster evidence of MDM. 2021 brought many eval... Read more
Staffing:
Make Retention the Centerpiece of Your Hiring Strategy
Make investments now to avoid the high costs of turnover later. Investing in your emplo... Read more
Make Retention the Centerpiece of Your Hiring Strategy
Make investments now to avoid the high costs of turnover later. Investing in your emplo... Read more
Reader Questions:
Find Meaning in MUEs
Question: I don't understand what the acronym MUE means in relation to the Centers for Med... Read more
Find Meaning in MUEs
Question: I don't understand what the acronym MUE means in relation to the Centers for Med... Read more
Reader Questions:
Consider Cost of Passing Fees to Patients
Question: Our practice is considering accepting credit cards for our patients' encounter t... Read more
Consider Cost of Passing Fees to Patients
Question: Our practice is considering accepting credit cards for our patients' encounter t... Read more
Reader Questions:
Grab Opportunity to Expand Telehealth
Question: Our rural practice has really taken advantage of the telehealth expansion to hel... Read more
Grab Opportunity to Expand Telehealth
Question: Our rural practice has really taken advantage of the telehealth expansion to hel... Read more
Best Practices:
Navigate New Provider Credential Waiting Period With These Useful Tips
Don't submit to myths or magical thinking when submitting claims for providers without cre... Read more
Navigate New Provider Credential Waiting Period With These Useful Tips
Don't submit to myths or magical thinking when submitting claims for providers without cre... Read more
Audits:
Pinpoint Medical Necessity with These Communication Tips
Frame documentation this way to support your practice's E/M coding and billing. “Base... Read more
Pinpoint Medical Necessity with These Communication Tips
Frame documentation this way to support your practice's E/M coding and billing. “Base... Read more
News You Can Use:
Don’t Miss These Important Updates on QPP and MIPS
The policy shifts may include a delay in MVP reporting. The Quality Payment Program will ... Read more
Don’t Miss These Important Updates on QPP and MIPS
The policy shifts may include a delay in MVP reporting. The Quality Payment Program will ... Read more
Reader Questions:
You Can Share This PHI in an Emergency
Question: I live in an area that is hit by hurricanes, and I want to be able to help patie... Read more
You Can Share This PHI in an Emergency
Question: I live in an area that is hit by hurricanes, and I want to be able to help patie... Read more
Reader Questions:
Heed This E/M Bullet Advice
Question: I am still getting used to the new rules for office/outpatient evaluation and ma... Read more
Heed This E/M Bullet Advice
Question: I am still getting used to the new rules for office/outpatient evaluation and ma... Read more
Reader Questions:
Know About This Provider Self-Disclosure Portal
Question: We recently hired a provider, and when I searched for their information on the L... Read more
Know About This Provider Self-Disclosure Portal
Question: We recently hired a provider, and when I searched for their information on the L... Read more
COVID-19:
Acknowledge The COVID-19 Tides Have Turned, Again
The Delta Variant is complicating the return to normalcy, plus tips for treating patients ... Read more
Acknowledge The COVID-19 Tides Have Turned, Again
The Delta Variant is complicating the return to normalcy, plus tips for treating patients ... Read more
Billing:
Prepare to Comply With These Balance Billing Changes for 2022
Hint: Keep this form on hand for patients who wish to proceed with out-of-network service... Read more
Prepare to Comply With These Balance Billing Changes for 2022
Hint: Keep this form on hand for patients who wish to proceed with out-of-network service... Read more
ICD-10:
Document More Context With These New ICD-10 Codes
The 2022 revisions have a strong focus on SDoH. Many of the 191 new ICD-10 codes that go... Read more
Document More Context With These New ICD-10 Codes
The 2022 revisions have a strong focus on SDoH. Many of the 191 new ICD-10 codes that go... Read more
Reader Questions:
Focus On These Topics for CPC Exam Success
Question: I'm deciding whether become a certified professional coder. Should I spend a lot... Read more
Focus On These Topics for CPC Exam Success
Question: I'm deciding whether become a certified professional coder. Should I spend a lot... Read more
Reader Questions:
Use This Resource for Federally Qualified Health Center Compliance
Question: I work at a FQHC and am preparing for a potential audit. Did the rules change at... Read more
Use This Resource for Federally Qualified Health Center Compliance
Question: I work at a FQHC and am preparing for a potential audit. Did the rules change at... Read more
Reader Questions:
Consider This E/M Billing Loophole During PHE
Question: One of the people in my group practice is a clinical social worker and doesn't u... Read more
Consider This E/M Billing Loophole During PHE
Question: One of the people in my group practice is a clinical social worker and doesn't u... Read more
Reader Questions:
Look to State Rules on E-Signatures
Question: Our small practice still sees a majority of our Medicare beneficiaries via teleh... Read more
Look to State Rules on E-Signatures
Question: Our small practice still sees a majority of our Medicare beneficiaries via teleh... Read more
Management:
Want to Promote a Cohesive Work Culture? Follow These Expert Tips
Data sounds boring, but it's your most versatile tool. While the intensity of the COVID-1... Read more
Want to Promote a Cohesive Work Culture? Follow These Expert Tips
Data sounds boring, but it's your most versatile tool. While the intensity of the COVID-1... Read more
Billing:
Pay Daily Attention to AR for Financial Health and Ease of Mind
Hint: Coders' coding choices directly impact payment If you're haunted by the claims sitt... Read more
Pay Daily Attention to AR for Financial Health and Ease of Mind
Hint: Coders' coding choices directly impact payment If you're haunted by the claims sitt... Read more
Medicare Part B:
Brush Up on Incident-To Billing
Hint: Knowing the letter of some definitions is key to accurate billing. Hint: Don't me... Read more
Brush Up on Incident-To Billing
Hint: Knowing the letter of some definitions is key to accurate billing. Hint: Don't me... Read more
Reader Questions:
Keep Up on Surprise Billing Regs
Question: What is going on with balance billing? Patients are constantly worried that our ... Read more
Keep Up on Surprise Billing Regs
Question: What is going on with balance billing? Patients are constantly worried that our ... Read more
Reader Questions:
Don’t Withhold Records Due to Balance
Question: One of our patients has a sizable balance and hasn't responded to requests for p... Read more
Don’t Withhold Records Due to Balance
Question: One of our patients has a sizable balance and hasn't responded to requests for p... Read more
Reader Questions:
Know Billing Rules for Multiple Providers in Same Location
Question: What's the difference between a NPI and a TIN? Texas Subscriber Answer: NPI... Read more
Know Billing Rules for Multiple Providers in Same Location
Question: What's the difference between a NPI and a TIN? Texas Subscriber Answer: NPI... Read more
HR Corner:
Revitalize Your Hiring With These Prep Tips
Setting expectations is key for everyone involved. While hiring a new team member is ofte... Read more
Revitalize Your Hiring With These Prep Tips
Setting expectations is key for everyone involved. While hiring a new team member is ofte... Read more
Telehealth:
Navigate Compliance as Pandemic Rules Change
Know how states' rules are changing, and what that means for you. The federal government... Read more
Navigate Compliance as Pandemic Rules Change
Know how states' rules are changing, and what that means for you. The federal government... Read more
Docoumentation:
Justify E/M Medical Necessity Coding With These Tips
Think of documentation as components in the patient's narrative. Medical necessity. You... Read more
Justify E/M Medical Necessity Coding With These Tips
Think of documentation as components in the patient's narrative. Medical necessity. You... Read more
Reader Questions:
Don’t Be Tempted by Duplicate Billing
Question: We have several claims that our payer is taking more than 30 days to process or ... Read more
Don’t Be Tempted by Duplicate Billing
Question: We have several claims that our payer is taking more than 30 days to process or ... Read more
Reader Questions:
Always Keep Audits in Mind
Question: Can a physician pick and choose what to bill? Maine Subscriber Answer: With... Read more
Always Keep Audits in Mind
Question: Can a physician pick and choose what to bill? Maine Subscriber Answer: With... Read more
Reader Questions:
Obtain ABNs and Submit Them With Confidence
Question: Can you offer any guidance on how to properly submit advanced beneficiary notice... Read more
Obtain ABNs and Submit Them With Confidence
Question: Can you offer any guidance on how to properly submit advanced beneficiary notice... Read more
Reader Questions:
Distinguish Exacerbation From Chronic When Coding Conditions
Question: Please settle this debate. One of our providers is saying that we should always ... Read more
Distinguish Exacerbation From Chronic When Coding Conditions
Question: Please settle this debate. One of our providers is saying that we should always ... Read more
Business:
Use These Tips to Showcase These Practice Strengths
Data may sound boring, but it's the key to unlocking some solid boosters. You know your p... Read more
Use These Tips to Showcase These Practice Strengths
Data may sound boring, but it's the key to unlocking some solid boosters. You know your p... Read more
Telehealth:
Enhance the Telehealth Experience With These Virtual Check-In Tips
Hint: Rely on this set of codes until the PHE ends. After a year-plus of navigating the ... Read more
Enhance the Telehealth Experience With These Virtual Check-In Tips
Hint: Rely on this set of codes until the PHE ends. After a year-plus of navigating the ... Read more
COVID-19:
Use These Strategies for Navigating Patient Fears
Prioritize sensitivity and avoid condescension. Regardless of your specialty, if you're p... Read more
Use These Strategies for Navigating Patient Fears
Prioritize sensitivity and avoid condescension. Regardless of your specialty, if you're p... Read more
Reader Questions:
Keep Wearing Your Mask
Question: Most of my colleagues and now many of our patients are fully vaccinated. Can I s... Read more
Keep Wearing Your Mask
Question: Most of my colleagues and now many of our patients are fully vaccinated. Can I s... Read more
Reader Questions:
Peep These Specialty Coding Credentials
Question: I'm interested in becoming a certified pediatric coder, but I'm confused about t... Read more
Peep These Specialty Coding Credentials
Question: I'm interested in becoming a certified pediatric coder, but I'm confused about t... Read more
Reader Questions:
Don’t Look to OIG for Info on Stark Law
Question: Does the Department of Health and Human Services Office of Inspector General (OI... Read more
Don’t Look to OIG for Info on Stark Law
Question: Does the Department of Health and Human Services Office of Inspector General (OI... Read more
Leadership and Communication:
Achieve Patient Scheduling Success With These Expert Tips
Hint: Establish office policies and apply them consistently. Scheduling may seem like an ... Read more
Achieve Patient Scheduling Success With These Expert Tips
Hint: Establish office policies and apply them consistently. Scheduling may seem like an ... Read more
HR Corner:
Set a Strong Foundation for New Providers
Organize and then communicate the needs of your other team members. Summer is coming, an... Read more
Set a Strong Foundation for New Providers
Organize and then communicate the needs of your other team members. Summer is coming, an... Read more
Security and Compliance:
Dig Deep on Business Associates’ Behavior
Don't take BAs at their word when their actions affect your business. “HIPAA-complian... Read more
Dig Deep on Business Associates’ Behavior
Don't take BAs at their word when their actions affect your business. “HIPAA-complian... Read more
Abide by These Office for Civil Rights Definitions
Prioritize protecting patient information. When it comes to HIPAA compliance, the carrot ... Read more
Prioritize protecting patient information. When it comes to HIPAA compliance, the carrot ... Read more
Reader Questions:
Respond This Way to a Demand Letter
Question: Our practice just received a “demand letter” from our Medicare Administrativ... Read more
Respond This Way to a Demand Letter
Question: Our practice just received a “demand letter” from our Medicare Administrativ... Read more
Reader Questions:
Be Careful With This Sensitive Material
Question: My clinic performs COVID-19 vaccinations. Can we dispose of the vials and s... Read more
Be Careful With This Sensitive Material
Question: My clinic performs COVID-19 vaccinations. Can we dispose of the vials and s... Read more
Reader Questions:
Keep Staff, Patient Vaccination Records Separate
Question: Is it OK to store staff and patient COVID-19 vaccination records in the sam... Read more
Keep Staff, Patient Vaccination Records Separate
Question: Is it OK to store staff and patient COVID-19 vaccination records in the sam... Read more
COVID-19:
Stay Abreast of These Updates on PPE and Vaccinations
Know why your organization should spring for the most effective measures against the coron... Read more
Stay Abreast of These Updates on PPE and Vaccinations
Know why your organization should spring for the most effective measures against the coron... Read more
Telehealth:
Use These Strategies to Bolster Telehealth Equity
The COVID-19 pandemic has accelerated the frequency and means that telehealth is utilized,... Read more
Use These Strategies to Bolster Telehealth Equity
The COVID-19 pandemic has accelerated the frequency and means that telehealth is utilized,... Read more
Compliance:
Know These Fraud Trends Related to COVID-19
See where the pandemic has jumpstarted enforcement. The pandemic may have stalled busines... Read more
Know These Fraud Trends Related to COVID-19
See where the pandemic has jumpstarted enforcement. The pandemic may have stalled busines... Read more
Reader Questions:
Highlight This Screening Claim Reality
Question: My office's physician performs a depression screening on some patients once a ye... Read more
Highlight This Screening Claim Reality
Question: My office's physician performs a depression screening on some patients once a ye... Read more
Reader Questions:
Figure Out Meanings of These Professional Certification Acronyms
Question: What do the various credentials surrounding billing/coding/ practice management ... Read more
Figure Out Meanings of These Professional Certification Acronyms
Question: What do the various credentials surrounding billing/coding/ practice management ... Read more
Reader Questions:
Schedule Vaccine Doses Like This
Question: Some of our nonmedical staff initially refused the COVID-19 vaccination but now... Read more
Schedule Vaccine Doses Like This
Question: Some of our nonmedical staff initially refused the COVID-19 vaccination but now... Read more
E/M Focus:
Understand Ins-and-Outs of These Evaluation and Management Services
Dive into this double-length article to double down on some 2021 changes to E/M services. ... Read more
Understand Ins-and-Outs of These Evaluation and Management Services
Dive into this double-length article to double down on some 2021 changes to E/M services. ... Read more
Billing and Coding:
Know These Legislative Updates for ‘Surprise Billing’
Don't miss the opportunity to learn what's in the No Surprises Act. Not to put too fine ... Read more
Know These Legislative Updates for ‘Surprise Billing’
Don't miss the opportunity to learn what's in the No Surprises Act. Not to put too fine ... Read more
COVID-19:
Know Who Qualifies As Healthcare Personnel
Hint: The term includes staff beyond direct care providers. At this point, most clinician... Read more
Know Who Qualifies As Healthcare Personnel
Hint: The term includes staff beyond direct care providers. At this point, most clinician... Read more
Reader Questions:
Take Certain Precautions for Pregnant Staff
Question: The data about COVID-19 and pregnancy has been a bit scarce, and the guidance al... Read more
Take Certain Precautions for Pregnant Staff
Question: The data about COVID-19 and pregnancy has been a bit scarce, and the guidance al... Read more
Reader Questions:
Expand Upon These Provider-Relevant Acronyms
Question: I am training for a position in billing in a practice and am trying to get the h... Read more
Expand Upon These Provider-Relevant Acronyms
Question: I am training for a position in billing in a practice and am trying to get the h... Read more
Reader Questions:
Preview Your Care Compare Rating
Question: Is there a way to see a Care Compare rating before it goes live to the public? ... Read more
Preview Your Care Compare Rating
Question: Is there a way to see a Care Compare rating before it goes live to the public? ... Read more
Policies and Protocols:
Carefully Weigh COVID-19 Vaccination Policies
Carefully Weigh COVID-19 Vaccination Policies Hint: Use flu vaccination policies as prec... Read more
Carefully Weigh COVID-19 Vaccination Policies
Carefully Weigh COVID-19 Vaccination Policies Hint: Use flu vaccination policies as prec... Read more
Person-Centered Care:
Manage Interactions With Patients With Dementia
Documenting the planning of comprehensive care can earn you more reimbursement. Seeing p... Read more
Manage Interactions With Patients With Dementia
Documenting the planning of comprehensive care can earn you more reimbursement. Seeing p... Read more
COVID-19:
Make Transparency Around Vaccine a Priority
Know that your day-to-day practice won't change much for a while. The various vaccinatio... Read more
Make Transparency Around Vaccine a Priority
Know that your day-to-day practice won't change much for a while. The various vaccinatio... Read more
Reader Questions:
Beware Gift Cards As Patient Incentives
Question: Are physicians allowed to give out gift cards or other incentives for pati... Read more
Beware Gift Cards As Patient Incentives
Question: Are physicians allowed to give out gift cards or other incentives for pati... Read more
Reader Questions:
Note This OCR Update for PHI
Question: Is my office violating HIPAA rules for releasing patients' protected health info... Read more
Note This OCR Update for PHI
Question: Is my office violating HIPAA rules for releasing patients' protected health info... Read more
Reader Questions:
Know These Focus Areas for Improper Payment Rates
Question: What are some areas my office can perform a self-audit on or otherwise focus on ... Read more
Know These Focus Areas for Improper Payment Rates
Question: What are some areas my office can perform a self-audit on or otherwise focus on ... Read more
Rules and Regulations:
Don’t Miss These Stark Law Updates
CMS cuts administrative burden through a boatload of exceptions. Whispers of changes to S... Read more
Don’t Miss These Stark Law Updates
CMS cuts administrative burden through a boatload of exceptions. Whispers of changes to S... Read more
Person-Centered Care:
Watch out for Elder Abuse
Know which signs and symptoms may not be obvious. Regardless of your practice's specialty... Read more
Watch out for Elder Abuse
Know which signs and symptoms may not be obvious. Regardless of your practice's specialty... Read more
Telehealth Compliance:
Keep on Top of Telehealth Realities During PHE
Hint: You can't bill for all phone calls to patients. As the pandemic continues, many pro... Read more
Keep on Top of Telehealth Realities During PHE
Hint: You can't bill for all phone calls to patients. As the pandemic continues, many pro... Read more
Reader Questions:
Understand These Finer Points of MDM
Question: The 2021 office and outpatient evaluation and management (E/M) guidelines for me... Read more
Understand These Finer Points of MDM
Question: The 2021 office and outpatient evaluation and management (E/M) guidelines for me... Read more
Reader Questions:
Take Heed of AAP Recoupment Strategy
Question: Our practice secured money through the Centers for Medicare & Medicaid Servi... Read more
Take Heed of AAP Recoupment Strategy
Question: Our practice secured money through the Centers for Medicare & Medicaid Servi... Read more
Reader Questions:
Beware Exam Room Air
Question: With the pandemic raging, I am pretty sure we are seeing patients who have COVID... Read more
Beware Exam Room Air
Question: With the pandemic raging, I am pretty sure we are seeing patients who have COVID... Read more