November 27, 2020 | By Grant Huang, CPC, CPMA Auditing evaluation and management (E/M) services furnished by resident physicians under the Medicare Primary Exception (PCE) already required a firm grasp of attestation and coding rules – but now COVID-19 throws another wrench into the works. In this audit tip, we will review the rules…
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December 4, 2020 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Last month, Paul Spencer, Senior Compliance Consultant of DoctorsManagement (DM) and I had the privilege of presenting to NAMAS members a course on performing a “gap” analysis in order to build a corporate compliance program that works in practice and is…
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December 18, 2020 | By Paul Spencer, CPC, COC “Risk adjustment,” as defined by CMS, is a method by which Medicare Advantage plans are compensated for demonstrating that the Medicare patients they cover under Part C plans are sicker than those covered under traditional Medicare or other plans. Increasingly, when I speak to practices,…
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January 22, 2021 | By Sean M. Weiss, CHC, CMCO, CEMA, CPMA, CPC-P, CMPE, CPC Welcome to 2021, “y’all” – as we say down yonder in the beautiful South! Let me begin by making it clear that the issues discussed in this article are not specific to any particular commercial or federal healthcare payer…
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January 15, 2021 | By Stephanie Allard, CPC, CEMA, RHIT CMS defines critical care as “the direct delivery by a physician(s) of medical care for a critically ill or injured patient. The care of such patients involves decision making of high complexity to assess, manipulate, and support central nervous system failure, circulatory failure, shock-like…
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