Billing Compliance Conflict? Navigate It with Confidence Billing Instructions Raising Concerns? Here’s a Pro-Level Playbook Written by: Toni Elhoms | Alpha Coding Experts In the complicated world of pay-and-chase healthcare reimbursement, medical billing is not just a back-office support function, but rather a regulatory landmine for healthcare organizations! From Stark Law to the False Claims Act…
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Are You Billing Ancillary Staff Correctly? Avoid Costly Errors Ancillary or Reimbursable? Why the Distinction Matters More Than Ever Written by: Sean Weiss | DoctorsManagement, LLC One of the biggest issues I address weekly for clients and law firms across the country is the use of “ancillary staff” vs. “reimbursable providers”. In the current environment, ensuring…
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Why Medical Claims Auditors Should Embrace Autonomy for Non-Physician Qualified Providers Embracing Provider Autonomy: A Smarter Approach to Medical Claims Auditing Written by: Jeana M. Singleton, Esq. | Brennan, Manna & Diamond, LLC As the U.S. healthcare landscape continues to evolve, so too must the perspectives of those who safeguard its financial integrity, including those working…
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CCM Under the Microscope: Are Your Providers Documentation-Ready? Written by: Christine Hall, CHC, CPC , CDEO, CPB, CPMA, CRC, CEMC, CPC-I Chronic Care Management (CCM) services are getting extra attention from Medicare Administrative Contractors (MACs) as part of their Target, Probe, and Educate (TPE) program. They are closely reviewing CCM claims for possible misuse, which…
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Before You Bill Incident To—Is the Treatment Plan Really There? Scott Kraft, CPC, CPMA, CEMC, CPA-RA Whenever you perform an audit under Medicare’s Incident to billing rules, you’re really auditing two different things. First, did the visit note support the code assigned and whether it included any documented changes to the patient’s treatment plan. Second,…
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