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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
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
Billing:
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
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
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
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
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
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
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
Reader Questions:
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Reader Questions:
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
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
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
Telehealth:
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
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
Reader Questions:
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
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
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
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
COVID-19:
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
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
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
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
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
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
Abide by These Office for Civil Rights Definitions
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
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
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
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
Telehealth:
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
Reader Questions:
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
Reader Questions:
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
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
COVID-19:
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
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
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
Policies and Protocols:
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
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
Reader Questions:
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
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
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
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
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
Reader Questions:
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
Reader Questions:
Beware Exam Room Air
Question: With the pandemic raging, I am pretty sure we are seeing patients who have COVID... Read more
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