We Have Always Done It This Way and Other Challenges in Education

By | 2018, Coding and Auditing
"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

By | 2018, Coding and Auditing
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

By | 2018, Coding and Auditing
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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Are Insurance Carriers Processing Claims in Compliance with ERISA Rules & Regulations

By | 2018, Coding and Auditing
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

By | 2018, Coding and Auditing
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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CMS 2019 fee schedule takes modifier 25 cuts, runs with them

By | 2018, Coding and Auditing
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

By | 2018, Coding and Auditing
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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