December 22, 2023 | By: Edward Baker, Of Counsel | Lieff Cabraser Heimann & Bernstein On September 30, 2023, the U.S. Department of Justice announced a $172 million False Claims Act (FCA) settlement with Cigna relating to the submission of invalid HCC diagnosis codes to CMS in order to increase Medicare Advantage member risk scores, and therefore,…
January 19, 2024 | 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, but the confusion on how to report Telehealth services continues to live on. When Medicare published its Final Rule last November 2nd,…
December 15, 2023 | By Stephanie Allard, CPC, CEMA, RHIT One area that keeps coming up in my conversations and education sessions is the definition and understanding, or misunderstanding, of the concept of a “problem addressed” during an encounter and how that is applied to E/M services. As treating practitioners document and as we…
December 8, 2023 | By Shannon O. DeConda The healthcare landscape is constantly evolving, and with dwindling reimbursement models, it is crucial to embrace innovative solutions for new healthcare delivery models to provide efficient and accessible services for patients. As we enter 2024, telehealth integration into medical practices has become necessary rather than convenient. As…
December 1, 2023 | By Natasha Timberlake, BSHCM, CRCR, CPC, CPB, COC, CRC, CPPM, CPMA, CHONC, AAPC Approved Instructor Reviewing the rules and guidelines regarding chemotherapy and therapeutic infusions and injections can be intimidating and confusing. Here are some helpful tips to help it become easier to understand. The first step is to review the…