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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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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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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August 20, 2021 | By J. Paul Spencer, CPC, COC In my role as a compliance consultant specializing in carrier audit response, a lot of items are brought to my attention on a daily basis, with the bearer of said items asking questions such as, “What’s this?” and “Do I have to respond to…
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March 26, 2021 | By Jamee Black, CPC, COC, CPMA The American Medical Association (AMA) recently released changes to the current Evaluation and Management (E/M) documentation guidelines for the Office and Other Outpatient Visit code range (99202–99215). The new guidelines focus on medical decision making (MDM), and are intended to more closely reflect the…
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