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NAMAS MEDICAL AUDITING AND COMPLIANCE

In a pediatric office, when is a fever considered a systemic symptom?

2021 E&M Changes, E/M Coding & Auditing, Shannon DeCondaBy NAMASOctober 12, 2021

  October 12, 2021 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT 2021 AMA guidance indicates that a general systemic symptom such as fever should not be considered a systemic system, but not all fevers fall in this category. The question typically posed is: what is the “magic” range that identifies it as no…

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Auditing Infusions, Hydrations and Injections

Compliance, Michele Stevens, Procedural Coding & AuditingBy NAMASOctober 15, 2021

  October 15, 2021 | By Michele Stevens If your facility and/or practice is providing infusion, hydration, and injection services they should be included in your annual compliance auditing plans to ensure proper coding guidelines are being followed and documentation education is not necessary to assist with any loss of revenue gaps. Infusion, hydration, and…

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How Does Identity Theft Affect My Family?

Career, Nicholas GoodwinBy NAMASOctober 8, 2021

October 8, 2020 | By Nicholas Goodwin, Esq. With all of the data breaches and stories about identity theft, it’s easy to get numb to all of the bad news and scary stories.  After all, how can identity theft really affect my family?  The answers might surprise you! First, the identity theft “crisis” isn’t any…

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Not All Remote Services are Telehealth: Know Your Codes!

E/M Coding & Auditing, Grant Huang, ICD-10By NAMASOctober 1, 2021

  October 1, 2021 | By Grant Huang, CPC, CPMA A year and half into the coronavirus pandemic, confusion still remains over a variety of remote services that are often lumped into the same category as telehealth but have their own unique codes and billing guidelines. CMS has given them the somewhat unwieldy label of…

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Executive Order and Garland Memo Breakdown

COVID-19, Legislative Action, News & Events, Sean WeissBy NAMASSeptember 24, 2021

  September 24, 2021 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Sean Weiss, DoctorsManagement Partner and Vice President of Compliance recently sat down with Ronald Chapman II, Esq. LLM of The Chapman Law Group to discuss and break down the Biden-Harris Executive Order and its impact on approximately 100 million American…

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MIPS – What Practices Need to Know to Avoid Financial Penalties

Compliance, Doug GrahamBy NAMASSeptember 17, 2021

  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…

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Audit Preparedness & the importance of an Audit Plan

Compliance, E/M Coding & Auditing, Stephanie AllardBy NAMASSeptember 14, 2021

    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…

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Getting Serious About Compliance

Compliance, Jesse OverbayBy NAMASSeptember 10, 2021

  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…

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When to Negotiate Insurance Contracts

Melody Irvine, Payer Rules, Revenue Cycle ManagementBy NAMASSeptember 3, 2021

  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,…

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Acute Uncomplicated vs Complicated Illness or Injury

ICD-10, Jamee BlackBy NAMASAugust 27, 2021

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…

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