July 2, 2021 | By Pam Brooks, MHA, COC, CPC As an auditor, you might find that the “meat and potatoes” of the audit is the most interesting part. Then you finish and it is time to pull together your findings into an executive summary. The best and most effective executive summary design is…
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June 25, 2021 | By Stephanie Allard, CPC, CEMA, RHIT When I ask practices if they have been through an external audit recently, they typically will state “no” or let me know if recent requests for a larger number encounter notes have been received. Through these conversations, I realize that they are not noticing…
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June 18, 2021 | By Bryan Meek, Esq., Brennan, Manna, and Diamond The pandemic has undisputedly changed the way in which Americans live their daily lives, including how they receive medical care. Patients have increasingly been receiving care via telemedicine, virtual check-ins, or e-visits in order to avoid physically going to their appointments and…
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June 4, 2021 | By Cheryl A. Cyrus, RHIT, CPMA, CDEO, CRC, Comforcehealth, Quality Assurance Auditor As of January 1, 2021, we have been given new Evaluation and Management Guidelines for Outpatient Office and Ambulatory services that encompass specific areas of risk defined in the SDOH (Social Determinants of Health). As a Profee auditor,…
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May 28, 2021 | Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content, innoviHealth Prolonged services codes were created to capture reimbursement for time spent with a patient that goes beyond the typical time associated with the primary service. We’re all aware of those patients that, unexpectedly, require so much prolonged provider…
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May 21, 2021 | By Stanley Nachimson, Nachimson Advisors April 5th 2021 was a major day in the history of patient data access. On that day, providers, vendors, and health information networks were required, under federal regulation, to make patient data available electronically to patients. The federal rule, 21st Century Cures Act: Interoperability, Information Blocking,…
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May 14, 2021 | By Jill Young, CPC, CEDC, CIMC The time has come for you to consider the “new time” method to determine the evaluation and management (E&M) coding for your office and other outpatient services. I use the phrase “new time” to differentiate it from the “old time” concept you are accustomed…
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May 7, 2021 | By Frank Cohen, Director of Analytics and Busines Intelligence It looks like the feds are moving quickly into recoupment audit mode in regards to telehealth and other services reported during the COVID-19 declared Public Health Emergency (PHE). Starting sometime the end of the first quarter of 2020, HHS came out…
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November 20, 2020 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS COVID-19 has been disrupting the healthcare environment for over a year now. Massive changes and evolutions have been introduced for how to code for services during COVID-19 including virtual visits, lab testing, and vaccinations. This article will cover COVID-19…
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April 23, 2021 | By By Rachel Rose, JD, MBA Early in 2019, the U.S. Department of Health and Human Services – Office for Civil Rights (HHS-OCR) announced the creation of an initiative to target violations of 45 CFR §164.524(b)(2) for not providing an individual with his/her requested protected health information (PHI) within…
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