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…
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June 10, 2022 | By Scott Kraft, CPMA, CPC The state and federal Public Health Emergency (PHE) declarations related to the COVID-19 pandemic created wide latitude for providers to render services via telehealth in order to prevent the higher risk of in-person contact for patients, providers, and staff. Some states have taken time during…
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We find ourselves halfway through 2022 and already we’re looking forward to the end of the year to see what those 2023 documentation guideline changes will be. I am most excited to see what those changes will be as we expand 2021 documentation guidelines into other types and places of E&M services and personally, I…
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June 3, 2022 | By Pam Brooks, MHA, COC, PCS, CPC, Fellow Federal oversight makes healthcare one of the most highly regulated industries in the United States. From a compliance perspective, that oversight poses significant risk for organizations who are unaware of the federal requirements, as well as providing opportunities for compliance professionals to…
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You know, most of the training I see out there, and even most of the training that I’m asked to do on E&M 2021 documentation guidelines surrounds MDM, so a lot of it isn’t even on time-based. So, set your watch. Let’s spend just a few minutes talking about…time. I’d like to start off by…
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May 27, 2022 | By Sonal Patel, CPMA, CPC, CMC, ICDCM I have been privileged to make my entrance into the world of healthcare and medical coding, specifically after my first career as an art historian dissolved way back in 2008 due to the recession. Mind you, I have taken all my research skills,…
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Have you ever had one of those questions that you think you have the answer to, but the more you read it, the more you’re swayed the other way — and then you read it again and you have an even different answer? Well, one of our NAMAS members (and a friend of mine) emailed…
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May 20, 2022 | By Toni Elhoms, CCS, CPC, CPMA, CRC Over the past year and a half, I have seen a significant increase in the volume of Unified Program Integrity Contractor (UPIC) investigations taking place in private physician practices. UPICs work on behalf of CMS to perform program integrity functions like detecting fraud,…
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I would like to make things right the first time so often, that they have errors and I need to make corrections -and the same is true for providers. In this post, I would like to approach the topic of addendums. The thing about addendums is… there are no clear-cut rules – except how to…
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November 5, 2021 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Terry Fletcher sits down with our very own Sean M. Weiss to discuss how physicians become audit targets. Terry joins Sean monthly on the compliance guy for her #TerryTuesday segment. We know you’ll enjoy it! Listen Now
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