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…
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,…
Preventative Testing – Unique Risk Stories – Listening to your patients By Jill Young CEMC, CPC, CEDC, CIMC September 27, 2024 I am going to tell you a story about my family and their journey with Preventive Testing and colon cancer. Names have been changed to protect the innocent and some facts may have been…
Getting it right: HCC in Primary Care Rhonda Buckholtz CPC, CPMA, CDEO, CRC, CHC, COPC September 20, 2024 Many of us have a love/hate relationship depending on your role in healthcare. From a provider standpoint, most often we think of these as an administrative burden with no upside. However, a shift in thinking is needed…