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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An ortho client emailed an interesting question this past week that is a good one to think through. For post-op major joint replacement patients, they would like to send their RN to the patient’s home for follow-up check-in visits. They wanted to provide this as an optional cash pay service. As a compliance forward auditor,…
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May 13, 2021 | By Rhonda Buckholtz, Owner, Coding and Reimbursement Experts For years we have talked about the culture in healthcare, especially for compliance purposes but for many practices that culture takes a back seat despite continued guidance. Culture is one of the most important features of a medical practice and for compliance…
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November 12, 2020 | By Priscilla J. Alfaro, MD, FAAP, CPC, CPMA, COC, CFE Genetic testing has grown exponentially over the last decade. The elimination of patent protection on human genes, the proliferation of next-generation sequencing (NGS) technology, and the rapid discovery of gene-disease connections have all contributed to this trend. * The rapidly…
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