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 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…
Non-Medically Necessary vs. Statutorily Excluded Services: Understanding the Differences Written by: Jennifer McNamara “That’s not covered.” It’s a phrase we hear all the time—but what does it really mean? There’s a definite distinction between non-medically necessary services and those that are statutorily excluded. Understanding the difference between non-medically necessary and statutorily excluded services is essential…
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…
The Auditor’s Role in Appeals: A Key Player in the Compliance Process Written by: Betty Hovey, BSHAM CCS-P CDIP CPC COC CPMA CPCD CPB CPCI The appeals process is a critical component of health care compliance, ensuring that denied claims are appropriately challenged and reconsidered. When providers and health care organizations receive claim denials, they…