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Practice Management Alert - 2024; Volume 24, Number 9
MPFS:
Here’s the Big News in the 2025 Proposed Rule
Big surprise: Another rate cut is coming. The Centers for Medicare & Medicaid Service...
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Reimbursement:
Avoid These 8 Common Medicare Billing Errors to Keep Pay Flowing
Watch those dates of service, MAC addresses, and more. Your provider documented a claim ...
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E/M Coding:
Bolster Your Distinct Time Billing Knowledge
Remember to bill with only one provider's number. Both the Centers for Medicare & Me...
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Reader Questions:
Include These Elements on Orientation and CE Lists
Question: How can I make sure my nonclinical staff are trained, especially on crucia...
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Reader Questions:
Use This Checklist for Medical Necessity
Question: What are the core tenets of documenting and illustrating medical necessity?...
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Reader Questions:
Distinguish NCD From LCD
Question: What's the difference between a national coverage determination (NCD) and...
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Practice Management Alert - 2024; Volume 24, Number 8
Best Practices:
Dissect Your Workflow to Streamline Operations
Hint: Patient satisfaction is all about setting expectations. In a medical practice, orde...
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News You Can Use:
Hear From Those Affected by the Change Healthcare Outage
Reinforce your skills with paper-based claims. More than four months have passed since ...
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More News:
Feds Focus On Physicians In June Enforcement
Prescription fraud, E/M upcoding, and more factor in latest settlements. You might have n...
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Modifiers:
Know These Modifier QW Dos and Don’ts
Hint: Check the CLIA list every time you're submitting a new lab test. Some coding modi...
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Reader Questions:
Beware of Licensing Obligations
Question: My practice has received communications from the American Medical Associati...
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Reader Questions:
Patients May Need to Choose Between Benefit Programs
Question: One of our patients mentioned to a nurse that he was receiving continuing g...
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Reader Questions:
Lean on Documentation for E/M of Services Not Actually Performed
Question: Can we count a provider's efforts to counsel a patient against a test as ev...
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Practice Management Alert - 2024; Volume 24, Number 7
Best Practices:
Try These Tips for Boosting Financial Literacy
Hint: Make sure you involve physicians, so they understand the ripples of their work. Ma...
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Continuing Education:
Use This Guidance to Improve Your Coding Education Process
Check out these tips for more effective onboarding. Coding education is an ongoing effor...
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Audits:
Establish Practice Protocols for Addressing A TPE Audit
Hint: Look at your MAC's focus to troubleshoot internal issues. Whether you've already s...
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Reader Questions:
Find Flexibility in Delegating Prior Authorizations
Question: If a patient's prescribed medication needs a prior authorization from their...
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Reader Questions:
Be Careful About Disclaimers on Records
Question: One of the physicians at our practice uses dictation software, and the vend...
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Reader Questions:
Get Clarity on Separate Procedures
Question: I've read that CPT® guidelines preclude coding some procedures together b...
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Practice Management Alert - 2024; Volume 24, Number 6
Best Practices:
Find Some Light in the Prior Authorization Maze
Hint: Don't forget to keep track of denials so you can troubleshoot your processes. Healt...
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Cybersecurity:
Take These 3 Tips, Use AI to Speed Through Unprocessed Claims
Here's how to streamline your workflow intelligently. Revenue cycle teams handle thousand...
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Reimbursement:
Avoid These 8 Common Medicare Billing Errors to Keep Pay Flowing
Watch those dates of service, MAC addresses, and more. Your provider documented a claim...
Read more
Reader Questions:
Focus on These Aspects of an Appeal Letter
Question: What information is crucial to include when I'm appealing a denied claim? ...
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Reader Questions:
Distinguish Medical Identity Theft From Other Types of Fraud
Question: Is medical identity theft a type of fraudulent claim? Minnesota Subscriber...
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Reader Questions:
Give Patients Tools to Boost Staff Morale
Question: How can I boost employee morale and keep track of all the great things my t...
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Reader Questions:
Get the Skinny on Medicare Overpayment Timeline
Question: We've heard that Centers for Medicare & Medicaid Services (CMS) says w...
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Practice Management Alert - 2024; Volume 24, Number 5
Best Practices:
Consider These Tips to Monitor Employee Productivity
Hint: Look at workers' records over a defined period of time. Practice managers know that...
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Documentation:
Study These Strategies for Setting Up a Solid CDI Process
Realize the benefits of regular self-audits. Comprehensive clinical documentation is the ...
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Training and Education:
Don’t Skimp On Sanction Policymaking, Feds Warn
Tip: Make employee training match duties. Stopping a data breach incident and retrievin...
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Reader Questions:
Sign-In Sheets Still OK
Question: One of the physicians in my practice demands we use a sign-in sheet—he says th...
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Reader Questions:
Rely on Addendums for EHR Mistake Corrections
Question: How should we correct a mistake in an electronic health record (EHR)? Montana S...
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Reader Questions:
Wearable Technology May Bring Peace of Mind
Question: I have several patients who suffer from epilepsy that is well controlled with me...
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Reader Questions:
Define Stable Condition
Question: Is there any difference between a chronic condition and a stable condition, espe...
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Practice Management Alert - 2024; Volume 24, Number 4
Industry News:
Did You Feel Shockwaves From the Blackcat Attack?
The cyberattack underscores the interconnectedness of U.S. healthcare. The Blackcat cybe...
Read more
Revenue:
Capture These Tips to Stall Denials
Make sure your billing team feels empowered to communicate well. Denials easily cross th...
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Payers:
Acknowledge the Need for Strong Relationships with Payers
Getting glimpses of the payer experience is a good first step. While providers may not be...
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Reader Questions:
Bulk Up Your Documentation With M.E.A.T.
Question: What, exactly, does M.E.A.T. stand for in the medical context? Oregon Subs...
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Reader Questions:
Employ Protections for Patient Signatures
Question: In our recent risk evaluation, we discovered that the electronic signatures...
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Reader Questions:
Be Careful With Complexity for Undiagnosed Condition
Question: Does an undiagnosed new problem with uncertain diagnosis automatically mean...
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Practice Management Alert - 2024; Volume 24, Number 3
Back to Basics:
Delve Into ‘Medical Necessity’
Hint: You may not need to conflate medical necessity with clinical care. The phrase “me...
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E/M Services:
Find Clarity on Providing E/M Services for Medicare Beneficiaries
And remember: Other payers may adopt these guidelines, too. In many coding roles, knowing...
Read more
Mythbusters:
Don’t Let the Internet Be the Wild West for Your Provider
Discover your responsibilities in protecting patient internet use data. Most websites co...
Read more
Reader Questions:
Respond to Record Requests With These Tips
Question: What's the best way to respond to a documentation request from another physician...
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Reader Questions:
Explore Potential Outcomes of SDOH
Question: I know there's a huge push to document social determinants of health (SDOH) for ...
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Reader Questions:
Distinguish NCD From LCD
Question: What's the difference between a national coverage determination (NCD) and a lo...
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Practice Management Alert - 2024; Volume 24, Number 2
Audits:
Take Preparations Now for TPE Resurgence
Don't risk making these common errors. The Centers for Medicare & Medicaid Services (...
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Best Practices:
Beware of Healthcare Workplace Violence
Look out for legislation and regulations that acknowledge dangers for healthcare personnel...
Read more
Modifiers:
Find Clarity With These Modifier FAQs
Boost your modifier usage knowledge to avoid reimbursement woes or headaches from audits. ...
Read more
Reader Questions:
Find CERT Info via Hub
Question: Are there any resources available to help folks navigate the Center for Me...
Read more
Reader Questions:
Acknowledge HC3 Advice
Question: We've been shopping for new software for our healthcare practice and haven'...
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Reader Questions:
Don’t Discount Smartwatch Data
Question: I am training as a scheduler, and a patient called in saying that their sma...
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Practice Management Alert - 2024; Volume 24, Number 1
Managed Care:
Pocket This Managed Care Primer
Shore up your managed care know-how before the OIG comes knocking. The Office of Inspecto...
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HR Corner:
Don’t Let a Stark Violation Masquerade as a Gift
Establish and review policies, and make sure staff understand their responsibilities. Th...
Read more
Modifiers:
Expand Your Knowledge of NCCI Edits
Hint: Understanding context is crucial information for accurate coding. Most coding sof...
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Reader Question:
Be Honest About Qualifying for Home Visit
Question: My provider wants to bill 99350 when performing a home visit via telehealth...
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Reader Question:
Think Beyond Reimbursement for Z Codes and Medical Necessity
Question: Do Z codes really affect reimbursement, or are they mostly designed to pad ...
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Reader Question:
Be Sensitive When Gathering Demographic Information
Question: I work as a scheduler and recently heard a colleague on the phone with a pa...
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