When Denials Attack: Outpatient E/M Services Denied with 2020 Rationale

  April 2, 2021 | By J. Paul Spencer, CPC, COC We now collectively find ourselves one calendar quarter into the new frontier of 2021 outpatient E/M services. Since January 1, I have fielded many questions from my professional contacts regarding how best to look at the newly-engineered medical decision making (MDM) component. As might…

After the Fire: Consideration of Risk-Based Contracts Post-COVID-19

  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,…