March 22, 2024 | By Carol Ittig, MBA, CMPE Introduction: In the fast-paced world of healthcare billing, clean claims are the key to maximizing revenue and minimizing headaches. A significant contributor to claim denials is inaccurate patient eligibility information. This article explores a multi-step approach to patient eligibility verification, empowering your team to submit clean…
March 15, 2024 | By Sonal Patel, BA, CPMA, CPC, CMC | CEO & Principal Strategist at SP Collaborative, LLC Introduction Did you know that under-documenting poses an audit hazard for any specialty provider? This is not spoken about too loudly by payors since their primary focus is identifying overpayments, rather than underpayments. Nevertheless, I…
March 8, 2024 | By Ashley Morgan, Esq. of Liles Parker PLLC A common issue that arises from a growing practice is how to structure the business to remain compliant while reducing potential liability concerns. Many times, practices grow and continue to operate in the same manner as they did when they only had one…
March 1, 2024 | By: Crystal May, CCS, CPC, CDEO, CPMA, CRC, Approved Instructor Breaking Down ICD-10-CM 7th Characters for Traumatic Fracture Care: Coders often get overwhelmed with coding traumatic fractures, typically due to the numerous 7th characters available. But coding them isn’t as scary as it seems once you understand how they break down.…
Updated 02-09-2024 | By: Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM As we all know the PHE, public health emergency, ended on May 11th, 2023, but the confusion on how to report Telehealth services continues to live on. When Medicare published their Final Rule last November…
February 23, 2024 | By Anonymous Source Electrocardiograms (EKG or ECG) and telemetry are indispensable tools in the field of cardiac health. They have revolutionized how healthcare professionals diagnose and monitor various heart conditions, from arrhythmias to heart attacks. EKGs record the heart’s electrical activity, while telemetry involves wireless data transmission from a patient’s heart…
February 16, 2024 | By Jennifer McNamara, CCS, CPC, CDEO, CPMA, CRC, COSC, CGSC, COPC, AAPC Approved Instructor | CEO, Healthcare Inspired, LLC Beyond Box Checking Compliance with reporting Evaluation and Management (E/M) services often takes center stage and has received much attention in recent years. They are the main revenue stream for Primary Care…
February 16, 2024 | By Betty A. Hovey, BSHAM, CCS-P, CDIP, CPC, COC, CPMA, CPCD, CPB I have been in the healthcare field for more than 35 years, and remember when we didn’t have Evaluation and Management (E/M) codes. Then, we went through the 1995 and 1997 guidelines from CMS. All the elements, boxes, borders…
February 2, 2024 | By Christine Hall, Senior Consultant, CHC, CPC, CPB, CPMA, CRC, CEMC, CPC-I Certified Instructor Navigating Healthcare Claims and Audits for Purchased Diagnostic Testing: In the complex world of healthcare, accurate reporting of services is crucial for ensuring quality patient care and fair compensation for medical providers. One significant aspect of this…
January 26, 2024 | By: Karlene Dittrich, CBCS, CPC, CPMA, CECCS | Certified ERISA/PPACA Claims Handling Compliance & Appeal Specialist The most common question I am asked in my seminars sharing relevant laws that support claims handling compliance requirements is: “But what about my contract?” Insurance companies write payer contracts in a way that leaves…