May 3, 2024 | By J. Paul Spencer, CPC, COC Primary care providers are increasingly becoming gatekeepers to mental and behavioral health care. This is due partly to increased awareness in the medical field of the overall health effects brought about by mental illness, as well as the addition of CPT codes for reimbursement that…
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May 10, 2024 | By: LaDonna D. Brown CPC, CPMA, CEMA When I was asked if I would like to be a contributor to NAMAS May articles, my first thought was absolutely. This is particularly timely as May is Mental Health Awareness Month, a crucial period for coders and auditors to reflect on the importance…
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March 22, 2024 | By Carol Ittig, MBA, CMPE Introduction: In the fast-paced world of healthcare billing, clean claims are the key to maximizing revenue and minimizing headaches. A significant contributor to claim denials is inaccurate patient eligibility information. This article explores a multi-step approach to patient eligibility verification, empowering your team to submit clean…
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September 29, 2023 | By Grant Huang, CPMA, CPC If you’ve never heard of principal care management (PCM) or chronic care management (CCM) services before, you’re not alone. Medicare introduced these new benefits for Part B beneficiaries in 2021 and 2022, respectively, but the agency’s own utilization data shows that adoption has been fairly…
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March 15, 2024 | By Sonal Patel, BA, CPMA, CPC, CMC | CEO & Principal Strategist at SP Collaborative, LLC Introduction Did you know that under-documenting poses an audit hazard for any specialty provider? This is not spoken about too loudly by payors since their primary focus is identifying overpayments, rather than underpayments. Nevertheless, I…
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March 8, 2024 | By Ashley Morgan, Esq. of Liles Parker PLLC A common issue that arises from a growing practice is how to structure the business to remain compliant while reducing potential liability concerns. Many times, practices grow and continue to operate in the same manner as they did when they only had one…
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Updated 02-09-2024 | By: Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM As we all know the PHE, public health emergency, ended on May 11th, 2023, but the confusion on how to report Telehealth services continues to live on. When Medicare published their Final Rule last November…
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February 16, 2024 | By Jennifer McNamara, CCS, CPC, CDEO, CPMA, CRC, COSC, CGSC, COPC, AAPC Approved Instructor | CEO, Healthcare Inspired, LLC Beyond Box Checking Compliance with reporting Evaluation and Management (E/M) services often takes center stage and has received much attention in recent years. They are the main revenue stream for Primary Care…
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March 1, 2024 | By: Crystal May, CCS, CPC, CDEO, CPMA, CRC, Approved Instructor Breaking Down ICD-10-CM 7th Characters for Traumatic Fracture Care: Coders often get overwhelmed with coding traumatic fractures, typically due to the numerous 7th characters available. But coding them isn’t as scary as it seems once you understand how they break down.…
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February 16, 2024 | By Betty A. Hovey, BSHAM, CCS-P, CDIP, CPC, COC, CPMA, CPCD, CPB I have been in the healthcare field for more than 35 years, and remember when we didn’t have Evaluation and Management (E/M) codes. Then, we went through the 1995 and 1997 guidelines from CMS. All the elements, boxes, borders…
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