Top 10 Compliance Pitfalls When Completing the CMS-1500 Form (And How to Avoid Them)

Top 10 Compliance Pitfalls When Completing the CMS-1500 Form (And How to Avoid Them) Written by: Beth Schleeper The CMS-1500 form is one of the most widely used claim forms in healthcare for submitting insurance claims for professional services. While it is a vital tool for reimbursement, there are several compliance pitfalls that healthcare providers…

The Auditor’s Role in Appeals: A Key Player in the Compliance Process

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…

Understanding Internal Self-Referrals

Understanding Internal Self-Referrals Written by: Ashley Morgan, Partner, Liles Parker PLLC Healthcare regulations outline legal risks related to internal self-referrals, making it important for both physicians and healthcare organizations to be informed about these issues. While internal referrals may seem like a natural part of integrated healthcare systems, they are heavily regulated under federal and…

Cosmetic Services in Professional Fee Clinics

Cosmetic Services in Professional Fee Clinics: Compliance Considerations Written by: Jesse Overbay | Associate Director & General Cousel @ DoctorsManagement, LLC Overview of Cosmetic Services in Professional Fee Clinics Across many healthcare settings, including specialized and general clinics, an increasing number of providers are incorporating cosmetic procedures in response to patient interest and evolving treatment…