Prevention of Patient Complaints and Payer Denials: Covered vs Non-Covered Preventive Services Written by: Pam Vanderbilt “I just got a bill for my free annual visit!! Sound familiar? Calls from patients who are upset because they got a bill for services they thought were covered. When I research these complaints, the issue causing the services…
Incident-to Billing Revisited: Chasing the 15% Written by: Shannon O. DeConda | NAMAS, a division of DoctorsManagement, LLC Incident-to billing, as defined by the Centers for Medicare & Medicaid Services (CMS), has long been both a point of interest and a source of confusion among healthcare providers. For many years, the prevailing advice among compliance…
A Stark Law Overview for Non-Legal Minds Written by: David M. Glaser, Shareholder | Fredrikson Health Law Stark is perhaps the most difficult of health law regulations, which may explain why there are so many misunderstandings about it. The first source of confusion is that the law is commonly called an “anti-self referral law.” But…
Understanding the Core Purpose of Certificate Of Need Regulations Written by: Trevor McElhaney, JD | Director of Consulting at DoctorsManagement, LLC What is a Certificate of Need? In the complex landscape of healthcare regulation, the Certificate of Need (CON) plays a significant role in determining the expansion and distribution of healthcare services. A Certificate of…
Nursing Visits in the Office: Navigating Risks and Staying Compliant Written by: Sonda Kunzi Let’s talk about nursing visits. If you have worked in a medical office, you’ve likely heard this term used to describe brief patient encounters with a medical assistant, nurse, or other clinical staff. Things like blood pressure checks, vaccine administration, suture…