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Category Archives: Revenue Cycle Management

Medical Necessity in 2022

Compliance, E/M Coding & Auditing, Legislative Action, Revenue Cycle ManagementBy NAMASJanuary 21, 2022

  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…

Should Your 2022 Audit Plan Include Paid Claims?

E/M Coding & Auditing, Procedural Coding & Auditing, Revenue Cycle ManagementBy NAMASJanuary 14, 2022

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…

Don’t Sleep On Small Claims Denials

Payer Rules, Revenue Cycle ManagementBy NAMASDecember 10, 2021

  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…

Revenue Cycle Analysis Presents Multiple Ways to Improve Compliance

Compliance, Revenue Cycle ManagementBy NAMASNovember 17, 2021

  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…

When to Negotiate Insurance Contracts

Payer Rules, Revenue Cycle ManagementBy NAMASSeptember 3, 2021

  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,…

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