Ancillary Staff vs. Reimbursable Providers: Navigating CMS and Commercial Payor Rules

Are You Billing Ancillary Staff Correctly? Avoid Costly Errors Ancillary or Reimbursable? Why the Distinction Matters More Than Ever Written by: Sean Weiss   |   DoctorsManagement, LLC One of the biggest issues I address weekly for clients and law firms across the country is the use of “ancillary staff” vs. “reimbursable providers”. In the current environment, ensuring…

Why Medical Claims Auditors Should Embrace Autonomy for Non-Physician Qualified Providers

Why Medical Claims Auditors Should Embrace Autonomy for Non-Physician Qualified Providers  Embracing Provider Autonomy: A Smarter Approach to Medical Claims Auditing Written by: Jeana M. Singleton, Esq.   |   Brennan, Manna & Diamond, LLC  As the U.S. healthcare landscape continues to evolve, so too must the perspectives of those who safeguard its financial integrity, including those working…

The Cautionary Tale of CMS’s New Policies for Global Surgery Payment Accuracy

The Cautionary Tale of CMS’s New Policies for Global Surgery Payment Accuracy January 10, 2025   |   Shannon O. DeConda, CPC, CPMC, CEMC, CEMA, CPA-EDU, CRTT, CPA-R   The Centers for Medicare & Medicaid Services (CMS) continues to refine policies to address the evolving needs of the healthcare system, with an eye on accuracy and fairness…

Understanding Independent Interpretation in E/M Coding: Three Essential Requirements

Understanding Independent Interpretation in E/M Coding: Three Essential Requirements Shannon O. DeConda, CPC, CPMA, CEMA, CPA-EDU October 4, 2024 In the realm of Evaluation and Management (E/M) coding, independent interpretation is an often misunderstood component of the Medical Decision Making (MDM) table. Proper documentation of independent interpretation is required to impact the MDM and, consequently,…