NAMAS humbly began as a educator and certifying body in medical auditing in 2007 and quickly grew into the noted resource for all medical auditing and compliance needs. Our team and faculty work hard to bring you membership resources, products, tools, and training that is not only timely and specific to medical auditing and compliance, but also that is specific to the needs of medical practices today. NAMAS staff are industry recognized experts who provide audits and consulting services to active clients which gives NAMAS the cutting edge to provide relevant training.
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November 10, 2023 | By Toni Elhoms, CCS, CPC, CPMA, CRC On countless occasions, I have heard physicians and healthcare providers balk at the notion of learning how to level their E/M services based on medical-decision-making (MDM), and some will even go as far as to say things like “I don’t have time…
CCM Under the Microscope: Are Your Providers Documentation-Ready? Written by: Christine Hall, CHC, CPC , CDEO, CPB, CPMA, CRC, CEMC, CPC-I Chronic Care Management (CCM) services are getting extra attention from Medicare Administrative Contractors (MACs) as part of their Target, Probe, and Educate (TPE) program. They are closely reviewing CCM claims for possible misuse, which…
Before You Bill Incident To—Is the Treatment Plan Really There? Scott Kraft, CPC, CPMA, CEMC, CPA-RA Whenever you perform an audit under Medicare’s Incident to billing rules, you’re really auditing two different things. First, did the visit note support the code assigned and whether it included any documented changes to the patient’s treatment plan. Second,…
Prescription Drug Management Requires More Than a Medication List Written by: Jill Young What documentation is required to show a provider is performing prescription drug management? It has been a question since the changes to the Office or Other Outpatient Services codes was announced by the American Medical Association (AMA) in 2021. The table Elements of Medical Decision…
Non-Medically Necessary vs. Statutorily Excluded Services: Understanding the Differences Written by: Jennifer McNamara “That’s not covered.” It’s a phrase we hear all the time—but what does it really mean? There’s a definite distinction between non-medically necessary services and those that are statutorily excluded. Understanding the difference between non-medically necessary and statutorily excluded services is essential…
Prevention of Patient Complaints and Payer Denials: Covered vs Non-Covered Preventive Services Written by: Pam Vanderbilt “I just got a bill for my free annual visit!! Sound familiar? Calls from patients who are upset because they got a bill for services they thought were covered. When I research these complaints, the issue causing the services…
Law vs. Health Law Fundamentals Written by: Rachel V. Rose, JD, MBA When was the last time you thought about what the “law” actually is and how it differs from what is commonly known as “health law”? Black’s Law Dictionary (2nd Ed.) provides two definitions: That which is laid down, ordained, or established. A rule…
