May 19, 2023 | By Terry A. Fletcher BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM Unless you have been climbing Mount Everest alone with no cell or Wi-Fi services for the past few months, I am certain you have heard of ChatGPT and its use as a form…
You know, sometimes, as coders and auditors, we’re the last ones to know about new things that come into the office, but sometimes we should be the first. This past week I got an e-mail from a friend (who is also a client and NAMAS member) who said their office received a new type of…
An ortho client emailed an interesting question this past week that is a good one to think through. For post-op major joint replacement patients, they would like to send their RN to the patient’s home for follow-up check-in visits. They wanted to provide this as an optional cash pay service. As a compliance forward auditor,…
January 21, 2022 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC While I am sure you have heard it several dozen times by now, I want to welcome you to 2022 because that is where the pleasantries end. 2022 will see Medical Necessity put front & center not only in audits…
January 14, 2022 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT In 2022, when we sit down to configure an audit plan, we often consider whether we will perform an audit retrospectively or prospectively and whether the sample will include evaluation and management (E&M) services, procedures or some combination of them both. What we…
December 10, 2021 | by Kelley Chappell Larkins, CPMA, CPC Are you ever tempted to just sweep those small claim denials under the rug? Do you sometimes wonder if it is worth the time and effort to figure out why a code, which will end up yielding $30, is being denied? Does it feel…
November 17, 2021 | By Scott Kraft, CPMA, CPC A physician practice revenue cycle analysis is really driven by that old saying “Follow the Money.” Along the journey, however, we learn a lot more about payment buckets and accounts receivable, as important as those factors are for practice operations. Very rarely do I perform…
September 3, 2021 | By Melody Irvine, CPC, CPMA, CEMC, CFPC, CPB, CPC-I, CCS-P, CMRS, CMRS, CMCS Often physicians’ groups sign insurance contracts without analyzing or performing an in-depth review of the agreement before they sign on the dotted line. Make sure you clearly understand the contract and language. Without fully understanding the contract,…
August 20, 2021 | By J. Paul Spencer, CPC, COC In my role as a compliance consultant specializing in carrier audit response, a lot of items are brought to my attention on a daily basis, with the bearer of said items asking questions such as, “What’s this?” and “Do I have to respond to…
July 2, 2021 | By Pam Brooks, MHA, COC, CPC As an auditor, you might find that the “meat and potatoes” of the audit is the most interesting part. Then you finish and it is time to pull together your findings into an executive summary. The best and most effective executive summary design is…