Practice Management Alert
Compliance:
Beware Responsibilities During Mergers or Acquisitions
The DOJ wants wrongdoers to find self-disclosure more palatable. Independently owned med... Read more
Beware Responsibilities During Mergers or Acquisitions
The DOJ wants wrongdoers to find self-disclosure more palatable. Independently owned med... Read more
Telehealth:
Rely on These Expert Tips for Telehealth Coding
Bonus: Use this clip-and-save chart to answer future questions. Patients and clinicians a... Read more
Rely on These Expert Tips for Telehealth Coding
Bonus: Use this clip-and-save chart to answer future questions. Patients and clinicians a... Read more
Best Practices:
Go Canny When Calling Someone Doctor
Californian DNPs are facing fines and potential license loss for going by ‘doctor.' I... Read more
Go Canny When Calling Someone Doctor
Californian DNPs are facing fines and potential license loss for going by ‘doctor.' I... Read more
Reader Question:
Note Grace Period for Redeterminations
Question: We are getting close to the 120-day deadline to submit a redetermination to... Read more
Note Grace Period for Redeterminations
Question: We are getting close to the 120-day deadline to submit a redetermination to... Read more
Reader Question:
Beware Side Hustle Solicitations
Question: A colleague who works at the front desk has a “side hustle” watching pe... Read more
Beware Side Hustle Solicitations
Question: A colleague who works at the front desk has a “side hustle” watching pe... Read more
Reader Question:
Don’t Equate ‘Acute’ With ‘New’ for MDM
Question: I noticed that the Number and Complexity of Problems Addressed column incl... Read more
Don’t Equate ‘Acute’ With ‘New’ for MDM
Question: I noticed that the Number and Complexity of Problems Addressed column incl... Read more
Best Practices:
Be Prepared to Care for Trans Patients
Gender mismatches on medical records can lead to denials. Knowing how to document and rep... Read more
Be Prepared to Care for Trans Patients
Gender mismatches on medical records can lead to denials. Knowing how to document and rep... Read more
Billing:
Waiving Co-Pays May Lead to Headaches
Find out whether what seems like financial accommodation can cause a huge headache. By de... Read more
Waiving Co-Pays May Lead to Headaches
Find out whether what seems like financial accommodation can cause a huge headache. By de... Read more
MIPS:
Check In On Options for MIPS Reporting Requirements
Hint: Keep your registration deadline in mind to maximize your flexibility. The year is ... Read more
Check In On Options for MIPS Reporting Requirements
Hint: Keep your registration deadline in mind to maximize your flexibility. The year is ... Read more
Reader Questions:
Know Why Your Provider Needs a Taxonomy Code
Question: I have never heard of taxonomy beyond the categorization of species, and now I'm... Read more
Know Why Your Provider Needs a Taxonomy Code
Question: I have never heard of taxonomy beyond the categorization of species, and now I'm... Read more
Reader Questions:
Follow MOLST Trajectory
Question: Does a patient need a new MOLST form for every facility they receive treatment? ... Read more
Follow MOLST Trajectory
Question: Does a patient need a new MOLST form for every facility they receive treatment? ... Read more
Best Practices:
Solve Apathy and Burnout Issues With These Expert Tips
Keeping up morale in the office can be a job in and of itself. No matter the size of your... Read more
Solve Apathy and Burnout Issues With These Expert Tips
Keeping up morale in the office can be a job in and of itself. No matter the size of your... Read more
MPFS:
Find Out What 2024 Will Bring for QPP
Beware: Small practices are at risk of being hit hardest. Every year, practices that acc... Read more
Find Out What 2024 Will Bring for QPP
Beware: Small practices are at risk of being hit hardest. Every year, practices that acc... Read more
Staffing:
Dial In Your Provider-to-Coder Ratio
Find out why specialty matters in coder productivity numbers. Figuring out how many coder... Read more
Dial In Your Provider-to-Coder Ratio
Find out why specialty matters in coder productivity numbers. Figuring out how many coder... Read more
Reader Questions:
Differentiate Between ‘Consent’ and ‘Authorization’
Question: I'm confused by some of the language in the Health Insurance Portability a... Read more
Differentiate Between ‘Consent’ and ‘Authorization’
Question: I'm confused by some of the language in the Health Insurance Portability a... Read more
Reader Questions:
Patient Health Records Need Not Feature Some Provider Opinions
Question: One of the providers in my practice likes to write their very personal impr... Read more
Patient Health Records Need Not Feature Some Provider Opinions
Question: One of the providers in my practice likes to write their very personal impr... Read more
Reader Questions:
Stay Informed on Other ‘Realities’
Question: I often treat elderly patients and have read a bit about nursing homes usi... Read more
Stay Informed on Other ‘Realities’
Question: I often treat elderly patients and have read a bit about nursing homes usi... Read more
ICD-10-CM Updates:
Prepare for Annual Updates
Know which codes were adjusted before the updates go into effect. It's that time of year ... Read more
Prepare for Annual Updates
Know which codes were adjusted before the updates go into effect. It's that time of year ... Read more
Knowledge Boost:
Power Your Z Code Reporting Prowess
Hint: Don't lean on SDoH just to help level up an encounter. Beginning Oct. 1, 2023, ther... Read more
Power Your Z Code Reporting Prowess
Hint: Don't lean on SDoH just to help level up an encounter. Beginning Oct. 1, 2023, ther... Read more
Documentation:
Bolster Your Query Skills
Navigating interactions with a provider doesn't need to make your stomach drop. Realizin... Read more
Bolster Your Query Skills
Navigating interactions with a provider doesn't need to make your stomach drop. Realizin... Read more
Reader Questions:
Rely on Later Signature in Certain Note Situations
Question: My office's electronic health record (EHR) system was down for a few hours ... Read more
Rely on Later Signature in Certain Note Situations
Question: My office's electronic health record (EHR) system was down for a few hours ... Read more
Reader Questions:
Beware Patient Medical Record Cost Regulations
Question: Can my practice charge patients for copies of their medical records? Or do ... Read more
Beware Patient Medical Record Cost Regulations
Question: Can my practice charge patients for copies of their medical records? Or do ... Read more
Reader Questions:
Look to Unclaimed Funds for Refund Guidance
Question: In an audit, I found out that my practice overpaid a patient. We mailed a r... Read more
Look to Unclaimed Funds for Refund Guidance
Question: In an audit, I found out that my practice overpaid a patient. We mailed a r... Read more
Compliance:
Know How to Measure the Success of Your Compliance Program
There's no “set it and forget it” when it comes to compliant compliance. There are s... Read more
Know How to Measure the Success of Your Compliance Program
There's no “set it and forget it” when it comes to compliant compliance. There are s... Read more
Credentialing:
Be Careful When Billing Encounters Under Another Physician’s Credentials
Hint: Situations where you can legally use another physician's information must meet spec... Read more
Be Careful When Billing Encounters Under Another Physician’s Credentials
Hint: Situations where you can legally use another physician's information must meet spec... Read more
Billing:
Know it When You See It: Legally Billing Services Under a Different Provider
Brush up on incident-to, Locum Tenems, and reciprocal billing. The Centers for Medicare &... Read more
Know it When You See It: Legally Billing Services Under a Different Provider
Brush up on incident-to, Locum Tenems, and reciprocal billing. The Centers for Medicare &... Read more
Payer Relations:
Dive Deep on Reporting Digital Health Encounters
Remember: Policies probably differ between payers. Digital health tools are probably her... Read more
Dive Deep on Reporting Digital Health Encounters
Remember: Policies probably differ between payers. Digital health tools are probably her... Read more
Reader Questions:
Define Patient-Initiated Services
Question: What counts as a patient-initiated service? Can a new patient schedule one? Ore... Read more
Define Patient-Initiated Services
Question: What counts as a patient-initiated service? Can a new patient schedule one? Ore... Read more
Reader Questions:
Follow MDM Rules on Lab Test Results
Question: If I order labs for a patient and also interpret the results, does the time... Read more
Follow MDM Rules on Lab Test Results
Question: If I order labs for a patient and also interpret the results, does the time... Read more
Reader Questions:
Clinical Staff May Contribute to CCM
Question: I know that typically the physician establishes a care plan in chronic care mana... Read more
Clinical Staff May Contribute to CCM
Question: I know that typically the physician establishes a care plan in chronic care mana... Read more
Customer Service:
Apply QI Principles to Patient Satisfaction
Hint: Documentation and data can illuminate weak points. Medical practices may not always... Read more
Apply QI Principles to Patient Satisfaction
Hint: Documentation and data can illuminate weak points. Medical practices may not always... Read more
News You Can Use:
Heed Payer Announcement on This E/M Policy Change
Bad news: The claims submission process may become more restrictive. Commercial carrier ... Read more
Heed Payer Announcement on This E/M Policy Change
Bad news: The claims submission process may become more restrictive. Commercial carrier ... Read more
HR Corner:
Be Careful Involving AI in Your Hiring Process
The EEOC warns that some AI functions may violate ADA, Title VII protections. Going throu... Read more
Be Careful Involving AI in Your Hiring Process
The EEOC warns that some AI functions may violate ADA, Title VII protections. Going throu... Read more
Reader Questions:
Beware WHO Warning on AI
Question: With the popularity of different artificial intelligence (AI) systems, are there... Read more
Beware WHO Warning on AI
Question: With the popularity of different artificial intelligence (AI) systems, are there... Read more
Reader Questions:
Distinguish Quality Assurance From Quality Control
Question: I'm putting together some training materials on quality in healthcare for my pra... Read more
Distinguish Quality Assurance From Quality Control
Question: I'm putting together some training materials on quality in healthcare for my pra... Read more
Reader Questions:
Rely On These Scheduling Mainstays
Question: Our organization is hiring a practice manager who wants to switch our scheduling... Read more
Rely On These Scheduling Mainstays
Question: Our organization is hiring a practice manager who wants to switch our scheduling... Read more
Reader Questions:
Pocket This Common Credentialing Terminology
Question: I know some of the acronyms related to physician credentialing, like CV and NPI,... Read more
Pocket This Common Credentialing Terminology
Question: I know some of the acronyms related to physician credentialing, like CV and NPI,... Read more
Documentation:
Stay on the Lookout for Impossible Time
Hint: ‘Suspicious' time can be a red flag. Ensuring your clinicians are paid for their... Read more
Stay on the Lookout for Impossible Time
Hint: ‘Suspicious' time can be a red flag. Ensuring your clinicians are paid for their... Read more
CMS Policy:
Find a Few Easter Eggs in Recent Final Rule
CMS offers to cut administrative burdens but rachets up oversight on MA. Federal agencies... Read more
Find a Few Easter Eggs in Recent Final Rule
CMS offers to cut administrative burdens but rachets up oversight on MA. Federal agencies... Read more
Mythbusters:
Dial in On Post-PHE Compliance
Regulators are scrutinizing your telehealth billing choices. The official end of the COV... Read more
Dial in On Post-PHE Compliance
Regulators are scrutinizing your telehealth billing choices. The official end of the COV... Read more
Reader Questions:
Make Sure Addenda are Signed, Dated
Question: If a healthcare practitioner makes an addendum to a patient's medical recor... Read more
Make Sure Addenda are Signed, Dated
Question: If a healthcare practitioner makes an addendum to a patient's medical recor... Read more
Reader Questions:
Unlisted Codes Can’t Be Modified
Question: Can I append a modifier to an unlisted CPT® code? I'm having trouble getti... Read more
Unlisted Codes Can’t Be Modified
Question: Can I append a modifier to an unlisted CPT® code? I'm having trouble getti... Read more
Reader Questions:
Bolster Communication Access for Neurodivergent Patients
Question: Our practice has several patients who are diagnosed with autism, ADHD, or T... Read more
Bolster Communication Access for Neurodivergent Patients
Question: Our practice has several patients who are diagnosed with autism, ADHD, or T... Read more
Claims and Denials:
Follow Through on These Reasons for Common Denials
Big surprise: Thorough documentation can prevent a lot of claims headaches. The last iss... Read more
Follow Through on These Reasons for Common Denials
Big surprise: Thorough documentation can prevent a lot of claims headaches. The last iss... Read more
Mythbusters:
Get the Skinny on Advance Care Planning Before OIG Audits You
Hint: Don't double dip on ACP and E/M services. The Department of Health and Human Servi... Read more
Get the Skinny on Advance Care Planning Before OIG Audits You
Hint: Don't double dip on ACP and E/M services. The Department of Health and Human Servi... Read more
Accessibility:
Prioritize Ease of Use for Deaf Patients
Federal agencies are willing to enforce penalties against noncompliant providers. Ensurin... Read more
Prioritize Ease of Use for Deaf Patients
Federal agencies are willing to enforce penalties against noncompliant providers. Ensurin... Read more
Accessibility:
Use These Strategies to Make Your Practice More Accessible
Aim for preserving patient dignity and privacy. If your practice doesn't offer many or ... Read more
Use These Strategies to Make Your Practice More Accessible
Aim for preserving patient dignity and privacy. If your practice doesn't offer many or ... Read more
Reader Questions:
Perform Due Diligence for Medicare Overpayments
Question: Who is responsible for identifying and correcting overpayment in any Center... Read more
Perform Due Diligence for Medicare Overpayments
Question: Who is responsible for identifying and correcting overpayment in any Center... Read more
Reader Questions:
Education May Be a Coder’s Best Bet
Question: My practice has hired a new provider, and the new provider's notes, which t... Read more
Education May Be a Coder’s Best Bet
Question: My practice has hired a new provider, and the new provider's notes, which t... Read more
Reader Questions:
Bust This F2F Time Myth
Question: One of our providers wants to bill an evaluation and management (E/M) visit... Read more
Bust This F2F Time Myth
Question: One of our providers wants to bill an evaluation and management (E/M) visit... Read more
Reader Questions:
Know When Rx Management Counts for OTC Drugs
Question: My provider sometimes tells patients to take ibuprofen or other commonly av... Read more
Know When Rx Management Counts for OTC Drugs
Question: My provider sometimes tells patients to take ibuprofen or other commonly av... Read more
Claims and Denials:
Tackle These Common Denials With These Tactics, Part I
Prevention is the best cure for denials and appeals. Few businesses can afford to leave ... Read more
Tackle These Common Denials With These Tactics, Part I
Prevention is the best cure for denials and appeals. Few businesses can afford to leave ... Read more
Coding:
Can Prior Authorizations Trigger an Audit?
Undercoding is just as problematic as overcoding, an expert says. The prior authorization... Read more
Can Prior Authorizations Trigger an Audit?
Undercoding is just as problematic as overcoding, an expert says. The prior authorization... Read more
Documentation:
Use CMS Guidelines as a Foundation for Clean Claims
Hint: Documentation is always a boon to fewer denials. Complete, accurate documentation ... Read more
Use CMS Guidelines as a Foundation for Clean Claims
Hint: Documentation is always a boon to fewer denials. Complete, accurate documentation ... Read more
HR Corner:
Don’t Skimp on Background Checks for New Hires
The prison sentences are steep for people who buy, rather than earn, diplomas. Managing s... Read more
Don’t Skimp on Background Checks for New Hires
The prison sentences are steep for people who buy, rather than earn, diplomas. Managing s... Read more
Reader Questions:
Don’t Seek BA Contracts With Mail Carriers
Question: I woke up in a panic last night: I've been sending bills with protected hea... Read more
Don’t Seek BA Contracts With Mail Carriers
Question: I woke up in a panic last night: I've been sending bills with protected hea... Read more
Reader Questions:
Check Record for Signature
Question: How do I know if a medical record is completed in a “timely” manner? C... Read more
Check Record for Signature
Question: How do I know if a medical record is completed in a “timely” manner? C... Read more
Reader Questions:
Ensure and Document Consent for Telehealth
Question: When doing a telehealth encounter, do you need to ask for telehealth-speci... Read more
Ensure and Document Consent for Telehealth
Question: When doing a telehealth encounter, do you need to ask for telehealth-speci... Read more
COVID-19:
Begin Your End-of-PHE Countdown Now
Know which waivers will expire — and which are here to stay. The COVID-19 public health... Read more
Begin Your End-of-PHE Countdown Now
Know which waivers will expire — and which are here to stay. The COVID-19 public health... Read more
Audits:
Boost Your C-Suite Communication Strategies
Make sure you know whether an attorney is involved before you begin. We shared some exper... Read more
Boost Your C-Suite Communication Strategies
Make sure you know whether an attorney is involved before you begin. We shared some exper... Read more
Procedure Coding:
Don’t Feel Stumped by AI Involvement
Find out pertinent CPT® guidance for AI-related procedures. If you missed the fact that ... Read more
Don’t Feel Stumped by AI Involvement
Find out pertinent CPT® guidance for AI-related procedures. If you missed the fact that ... Read more
Reader Questions:
Distinguish ‘Consult’ From ‘Referral’
Question: Some of our providers use “consultation” and “referral” interchange... Read more
Distinguish ‘Consult’ From ‘Referral’
Question: Some of our providers use “consultation” and “referral” interchange... Read more
Reader Questions:
Define ‘Independent Historian’
Question: I am working as a coder for the first time and one of my providers wrote th... Read more
Define ‘Independent Historian’
Question: I am working as a coder for the first time and one of my providers wrote th... Read more
Reader Questions:
Don’t Bill New Patients for These E/M Codes
Question: I work for a surgery practice, and we offer phone consultations for new pat... Read more
Don’t Bill New Patients for These E/M Codes
Question: I work for a surgery practice, and we offer phone consultations for new pat... Read more
Reader Questions:
Don’t Bill Beneficiaries for Medicare-Covered Services
Question: Can a practice send a Medicare beneficiary an advanced notice of noncoverag... Read more
Don’t Bill Beneficiaries for Medicare-Covered Services
Question: Can a practice send a Medicare beneficiary an advanced notice of noncoverag... Read more
New You Can Use:
Find Out What CMS Thinks About 2020-2021 Claims Payments
Surprise: CMS says the improper payment rate was 7.46 percent. If your Medicare claims do... Read more
Find Out What CMS Thinks About 2020-2021 Claims Payments
Surprise: CMS says the improper payment rate was 7.46 percent. If your Medicare claims do... Read more
Staffing:
Understand How Noncompete Agreements Affect You
Surprise: Healthcare is mentioned specifically in the proposed rule. The Federal Trade Co... Read more
Understand How Noncompete Agreements Affect You
Surprise: Healthcare is mentioned specifically in the proposed rule. The Federal Trade Co... Read more
Audits:
Look for Educational Opportunities During Audits and Training
Hint: The easiest way to gain experience may be off the clock. Hear what three experts h... Read more
Look for Educational Opportunities During Audits and Training
Hint: The easiest way to gain experience may be off the clock. Hear what three experts h... Read more
Reader Questions:
Defer to State Law if More Stringent
Question: What does the Centers for Medicare & Medicaid Services (CMS) mean when ... Read more
Defer to State Law if More Stringent
Question: What does the Centers for Medicare & Medicaid Services (CMS) mean when ... Read more
Reader Questions:
Locum Tenens is Not a Loophole Post-Termination
Question: Can a locum tenens arrangement be used for a physician who has been termina... Read more
Locum Tenens is Not a Loophole Post-Termination
Question: Can a locum tenens arrangement be used for a physician who has been termina... Read more
Reader Questions:
Distinguish ‘RHC’ from Rural Clinics
Question: An acquaintance coder I know from networking online just started working at... Read more
Distinguish ‘RHC’ from Rural Clinics
Question: An acquaintance coder I know from networking online just started working at... Read more
Audits:
Try These Strategies When Reporting Audit Findings to a Provider
Don't forget: You can ask your manager for backup. The worst part of any audit may be a s... Read more
Try These Strategies When Reporting Audit Findings to a Provider
Don't forget: You can ask your manager for backup. The worst part of any audit may be a s... Read more
MPFS:
Find Out How to Tighten Your Belt Before the 2023 CF Hit
The final reduction is even higher than what CMS initially proposed. The Centers for Med... Read more
Find Out How to Tighten Your Belt Before the 2023 CF Hit
The final reduction is even higher than what CMS initially proposed. The Centers for Med... Read more
Best Practices:
Wary of Litigation? Try This 1 Little Thing
Hint: Assuage hurt feelings for both patients and employees. One simple — but possibly... Read more
Wary of Litigation? Try This 1 Little Thing
Hint: Assuage hurt feelings for both patients and employees. One simple — but possibly... Read more
Reader Question:
If You’re Not a Physician, Don’t Alter CNMs
Question: My billing supervisor erased something that the doctor wrote on a certifica... Read more
If You’re Not a Physician, Don’t Alter CNMs
Question: My billing supervisor erased something that the doctor wrote on a certifica... Read more
Reader Question:
Prepare Remote Desktops for Cybersecurity Threat
Question: Can I do anything to protect my practice's remote coders' computers from th... Read more
Prepare Remote Desktops for Cybersecurity Threat
Question: Can I do anything to protect my practice's remote coders' computers from th... Read more
Reader Question:
Medicare Doesn’t Cover This Routine Exam
Question: What's the difference between an annual well visit and a well-woman visit? ... Read more
Medicare Doesn’t Cover This Routine Exam
Question: What's the difference between an annual well visit and a well-woman visit? ... Read more