Are You Billing Ancillary Staff Correctly? Avoid Costly Errors Ancillary or Reimbursable? Why the Distinction Matters More Than Ever Written by: Sean Weiss | DoctorsManagement, LLC One of the biggest issues I address weekly for clients and law firms across the country is the use of “ancillary staff” vs. “reimbursable providers”. In the current environment, ensuring…
Why Medical Claims Auditors Should Embrace Autonomy for Non-Physician Qualified Providers Embracing Provider Autonomy: A Smarter Approach to Medical Claims Auditing Written by: Jeana M. Singleton, Esq. | Brennan, Manna & Diamond, LLC As the U.S. healthcare landscape continues to evolve, so too must the perspectives of those who safeguard its financial integrity, including those working…
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…
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…