• [addtoany]
    This week is Take Care of You Week - specifically, take care of your heart. We have two back-to-back days commemorating cardiovascular care. Wednesday, September 26th is National Women's Health & Fitness Day, and just three days later, Saturday, September 29th is World Heart Day. Why   Read more..
    Posted on 26 Sep, 2018
    Cardiovascular Care Takes the World’s Stage
  • [addtoany]
    The Office of Inspector General (OIG) was formed in 1976 by President Gerald Ford through the Inspector General Act. Since then, the OIG has been key in fighting waste, abuse, and fraud in Medicare, Medicaid, and other Health and Human Services programs and is the   Read more..
    Posted on 11 Sep, 2018
    Nail Down the Office of Inspector General’s (OIGs) Role
  • [addtoany]
    Are you up to speed on the 2018 CPT and HCPCS codes for telemedicine, finalized in the Medicare Physician Fee Schedule (MPFS). Read on for an overview of key updates you don’t want to miss. HCPCS codes: G0296 (Counseling visit to discuss need for lung cancer   Read more..
    Posted on 30 Aug, 2018
    Master the 2018 Telemedicine Codes
  • [addtoany]
    Medicare determined that a practice had been billing X-rays globally for years, when it should have only billed X-rays with a modifier 26 for the professional interpretation of the service, as the practice didn’t own the X-ray equipment. The fallout of this oversight included an   Read more..
    Posted on 23 Aug, 2018
    How to Chart Out the Medical Audit Process
  • [addtoany]
    Are you on top of CMS documentation guidelines? The following points identify CMS guidelines for correct documentation that supports and validates the claim submitted for services/procedures: The record of the encounter/episode of care should be complete and legible Documentation should include: Reason for the encounter Assessment,   Read more..
    Posted on 10 Aug, 2018
    Conquer Common Documentation Errors Identified by CERT & RAC
  • [addtoany]
    Inpatient consultations via telemedicine is improving lives. These encounters facilitate the delivery of certain services that might otherwise be unavailable to a patient located at an originating site. While you can’t use telemedicine to provide E/M inpatient encounters, you can use them to substitute for a   Read more..
    Posted on 27 Jul, 2018
    Conquer Inpatient Telemedicine Consultations
  • [addtoany]
    Backstory: Why NCCI was Started The Centers for Medicare and Medicaid Services (CMS) is the agency responsible for the implementation of the National Correct Coding Initiative (NCCI), which was developed to encourage correct coding procedures on the national level and to reduce inappropriate coding that   Read more..
    Posted on 20 Jul, 2018
    Nip Errors in the Bud with the NCCI and MUEs
  • [addtoany]
    Medicine codes for both therapeutic and diagnostic services include injections, physical medicine, and rehabilitation services. These are some of the most difficult services to audit and, as a result, some of the most frequently audited in the medicine section of CPT®. Injections and infusions Injections and   Read more..
    Posted on 10 Jul, 2018
    How to Overcome Challenges in Medicine Auditing
  • [addtoany]
    National healthcare fraud is on the upswing, with a 400% increase in annual takedowns since 2013—and this, despite sequestration of mandatory funding for the Department of Justice (DOJ), the Department of Health & Human Services (HHS), the Office of Inspector General (OIG), and the FBI. Take   Read more..
    Posted on 29 Jun, 2018
    400% Rise in Healthcare Fraud Takedowns
  • [addtoany]
    Recoup lost revenue by following up on denials.   After a claim has been properly documented, coded, and submitted for payment, a few things could happen. Hopefully, the insurer pays the claim and the office receives the appropriate reimbursement. But there are other scenarios that could   Read more..
    Posted on 25 Jun, 2018
    Don’t Take Rejections Lying Down

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