"We Have Always Done It This Way" and Other Challenges in Education Omega Renne, CPC, CPCO, CPMA, CEMC, CIMC Compliance Consultant for DoctorsManagement This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. As coders, auditors, and compliance professionals, we are...
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Understanding Risk Adjustment: When Capturing HCC's is Not a Part of My Work Flow Stephanie Allard, CPC, CEMA, RHIT Senior Compliance Consultant for DoctorsManagement This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. Many facilities are forming departments to work...
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Prolonged Services: It's Not Just About Time J. Paul Spencer, COC, CPC Senior Compliance Consultant for DoctorsManagement This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. Time, as it applies to E/M codes, has often been viewed as an "if/then"...
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When to Use Modifier 25 and Modifier 57 on Physician Claims Scott Kraft, CPC, CPMA Senior Compliance Auditor for DoctorsManagement This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. The biggest thing modifiers 25 and 57 have in common is that...
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Are Insurance Carriers Processing Claims in Compliance with ERISA Rules & Regulations Maxine Collins, MBA, CPA, CPMC, CMOM, CMIS Director of Compliance, Audits and Education at CoreMD Partners, LLC This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. Per the...
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Tips for Voluntary Refunds David Glasser, JD Shareholder with Fredrikson & Byron This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. Choosing your words carefully is wise in a highly regulated environment like health care. That is particularly true when...
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Signs that You Need an Associate Doctor By Jonathan Ford Hughes| August 7, 2018 If you’re like most doctors in private practice who find themselves in the back half of their careers, you might be thinking that it’s time to bring on an associate doctor and retire comfortably. But can you, your patients, and your...
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FREE WEBINAR: Impact of the Proposed 2019 E&M Changes The plethora of recent papers and articles concerning the new proposed Medicare 2019 E&M code changes have focused solely on the coding and documentation components. What seems to have been ignored, is both the financial impact as well as the impact on physician compensation packages tied to...
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CMS 2019 fee schedule takes modifier 25 cuts, runs with them Grant Huang, CPC, CPMA Director of Content With so much focus on the potential E&M reimbursement reductions that could result from the CMS proposed rule changes in its 2019 Physician Fee Schedule (PFS), there’s another crucial E&M provision that’s gotten precious little attention – but could significantly...
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Getting the Right Eligibility Information for Payment - Your Rights and Health Plan's Requirement Stanley Nachimson Principal, Nachimson Advisors, LLC This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. We need timely and accurate patient information to bill health plans...
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