June 14, 2024 | By: Jodi Beebe, CPC, COBGC, CPMA, CPB One physician’s group quest for revenue cycle greatness… As payer rules and edits become increasingly strict, finding ways to improve coding accuracy and foster a corporate culture of compliance is crucial. A significant return on investment exists for maintaining an excellent revenue cycle within any…
May 24, 2024 | By: Lindsey Chatelain, CPC, CRC If you have ever been the subject of a payer audit, you know it can be daunting. Not only does it delay payment and increase the number of records requests your staff has to process, but getting off the audit is also difficult. It is achieved only…
March 29, 2024 | By: Teresa Schrage, RDCS, RVT, CPC, CPMA Reporting an E/M with separately reported services continues to be a topic of discussion amongst coders, auditors, and providers. First, let’s review what a significant, separately reported E/M is and what identifies the service. An E/M is significant and separately identifiable from a procedure/service…
April 26, 2024 | Sean M. Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC The perennial inquiry into the scope of services that nurses and ancillary support staff may offer under physician supervision remains a frequent topic of discussion. Furthermore, I frequently encounter situations where the concept of “incident-to” care is central to the controversy.…
April 5, 2024 | By: Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM (updated 4/6/2024) 2024 brought new HCPCS codes that Medicare, Medicare Advantage and some 3rd-party Commercial plans that they will now pay for. One of those codes is the G0136; that is the Social Determinate…
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…
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…
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…
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…
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…