July 8, 2022 | By Terry Fletcher, BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM According to the U.S. Department of Health and Human Services (HHS) and the Office of Inspector General website, things have changed in regard to the controversial question of mandatory compliance plans. The Federal Register…
July 1, 2022 | By Stephanie Allard, CPC, CEMA, RHIT After all the hype surrounding the upcoming Cigna policy regarding modifier 25 and pre-bill reviews, it seems as if Cigna is not planning on implementing the policy as planned on August 14, 2022. At the time I am writing this, there is recent news…
June 24, 2022 | By Rachel Rose, JD, MBA By now, providers should appreciate that there are legal ways to structure most arrangements. One area that is fraught with peril are physician owned distributorships, which are also referred to as “PODs”. PODs are defined as: “physician-owned entities that derive revenue from selling, or arranging…
When you’re providing audit feedback or education for providers, have you been receiving pushback or comments from providers regarding qualification time statements? When we think about the qualification statement that is required, well…best practices, for our time-based E&M services, those qualification statements are really needed in order to qualify the amount of time that our…
June 17, 2022 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC I am constantly being asked what can be done when government and commercial payors are slow-walking claims for payment. The simple answer is to know your state and federal law. First, let’s tackle the federal law which is 42 CFR…