September 17, 2021 | By Doug Graham, Senior Management Consultant and Director of Concierge Medicine Services, DoctorsManagement By law, CMS is required to structure the MIPS program such that 1 out of 2 clinicians will be penalized each year. Non-compliance, submitting inaccurate or incomplete data, or failing to meet the points threshold and category…
September 15, 2021 | By Stephanie Allard, CPC, CEMA, RHIT I am looking forward to the NAMAS 13th Annual Auditing and Compliance Conference at the Wyndham Grand Clearwater Beach on December 5th through 8th! This year, I am excited to be a part of the E&M Auditing track on Tuesday, December 7th and…
September 10, 2021 | By Jesse Overbay, JD By now, most health systems, practices, and providers should know that the Office of Inspector General (“OIG”) has been stressing the importance of creating and abiding by a compliance plan since the passage of the patient Protection and Affordable Care Act in 2010. In its own…
September 9, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Never in our lifetime have we encountered a more controversial subject than the daily buzz we hear from co-workers, news networks, social media, and the like related to COVID-19. While most of us are not sitting in a front-line environment (anymore), we…
September 3, 2021 | By Melody Irvine, CPC, CPMA, CEMC, CFPC, CPB, CPC-I, CCS-P, CMRS, CMRS, CMCS Often physicians’ groups sign insurance contracts without analyzing or performing an in-depth review of the agreement before they sign on the dotted line. Make sure you clearly understand the contract and language. Without fully understanding the contract,…
August 31, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Had you asked me 18 years ago when I first started out as a consultant if I would ever be a public speaker on national speaking circuits, my resounding answer would have been “Haha, no way!”. Today, I am bestowed the honor…
August 27, 2021 | By Jamee Black, CPC, COC, CPMA One of the most difficult determinations of Number and Complexity of Problems Addressed is complicated vs uncomplicated. When selecting Number and Complexity of Problems Addressed, the complication of treatment required should not be considered. The Risk of Complications of Patient Management is where the treatment…
August 20, 2021 | By J. Paul Spencer, CPC, COC In my role as a compliance consultant specializing in carrier audit response, a lot of items are brought to my attention on a daily basis, with the bearer of said items asking questions such as, “What’s this?” and “Do I have to respond to…
August 13, 2021 | By Grant Huang, CPC, CPMA With Americans having widespread access to effective vaccines, the COVID-19 pandemic is finally fading into the background for most practices, but the issue of compliance is once again rearing its multi-faceted head. This time, after billions of dollars in federal spending as part of pandemic…
August 6, 2021 | By Sean M. Weiss, CHC, CMCO, CEMA, CPMA, CPC-P, CMPE, CPC 2021 has lived up to what, in my mind, I’ve dubbed back in December of 2020 “The Year of The Audit”. The number of “raids”, resolution agreements, settlement agreements, and audits by RACs, SMRCs, UPICs, and SIUs have…