Auditing Critical Care Services
January 15, 2021 | By Stephanie Allard, CPC, CEMA, RHIT CMS defines critical care as “the direct delivery by a physician(s) of medical care for a critically ill or…
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Better late than never: Stimulus bill salves pain of conversion factor cut, also delays G2211
January 7, 2021 | By Grant Huang, CPC, CPMA The 2021 Physician Fee Schedule (PFS) had included the largest one-year reduction to the Medicare conversion factor (CF) in more than…
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Changes to Stark May Require Tweaks to the Physician Compensation Formula
January 8, 2021 | By David Glaser In early December, the Centers for Medicare and Medicaid Services (CMS) issued new rules that dramatically revise the Physician Self-Referral Law, commonly…
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The SOAP Note Revisited in 2021
January 1, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT While conducting a 2021 E&M Physician Training event for a client, like right in the middle of the…
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What You Need to Know About Prolonged Services in 2021
December 25, 2020 | By By Grant Huang, CPC, CPMA The New Year is nearly upon us and with it, implementation of the much-talked-about 2021 E/M guidelines for office/outpatient…
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After the Fire: Consideration of Risk-Based Contracts Post-COVID-19
December 18, 2020 | By Paul Spencer, CPC, COC “Risk adjustment,” as defined by CMS, is a method by which Medicare Advantage plans are compensated for demonstrating that the…
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It’s Beginning to Look a Lot Like Christmas!
December 11, 2020 | By Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA, CEMA-O There is a long-standing rule in our family that Christmas is not allowed to start…
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Finally: CMS releases 2021 final rule; no major surprises seen
December 15, 2020 | By By Grant Huang, CPC, CPMA At long last, CMS has published its Medicare Physician Fee Schedule (PFS) final rule, and while some of the…
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Performing a Gap Analysis
December 4, 2020 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Last month, Paul Spencer, Senior Compliance Consultant of DoctorsManagement (DM) and I had the privilege of…
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COVID-19: Resident Services Under the Medicare Primary Exception
November 27, 2020 | By Grant Huang, CPC, CPMA Auditing evaluation and management (E/M) services furnished by resident physicians under the Medicare Primary Exception (PCE) already required a firm…
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