All - DoctorsManagement All - DoctorsManagement

Caveat Emptor

By | 2019, Regulatory Compliance, Sean Weiss
Caveat Emptor “The Truth About Evaluation and Management Services & Proprietary Algorithms” by Sean Weiss, Partner & VP of Compliance We have, and will remain in, an industry dominated by fancy terms like predictive analytics and artificial intelligence and words such as proprietary determined by marketing teams at various vendors trying to get their piece...
Read More

“But All My Friends are Doing it.”

By | 2019, Coding and Auditing
"But All My Friends are Doing it." Pam Vanderbilt, CPC, CPMA, CPC-I, CPPM, CEMC, CEMA, CEMA-O This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. At some point in our younger lives, we all probably used some version of the...
Read More

Business Associate Agreement

By | 2019, Regulatory Compliance, Sean Weiss
Business Associate Agreement “Make Sure You Have Them on File” by Sean Weiss, Partner & VP of Compliance The Health Insurance Portability and Accountability Act of 1996 (HIPAA), also referred to as Public Law 104-191, has been around for more than two decades now. For the first 15 years or so, there was not much...
Read More

Co-Management Agreements

By | 2019, Regulatory Compliance, Sean Weiss
Co-Management Agreements “Aligning Hospitals and Providers” by Sean Weiss, Partner & VP of Compliance While the industry is split between physician practices remaining independent versus being acquired and thus being employed, there are other type arrangements that are taking place which have been around for quite a while (mid-00’s); I am referring to Co-management Agreements....
Read More

Cigna, UnitedHealth to stop paying for consults in October

By | 2019, Regulatory Compliance
Cigna, UnitedHealth to stop paying for consults in October Grant Huang, CPC, CPMA Director of Content Two major commercial payers will stop reimbursing consultation E/M services (CPT codes 99241-99255) in October, finally joining CMS in ditching the high-paying but sometimes confusing code set. UnitedHealth made its announcement in its March 2019 newsletter, stating that it...
Read More

Medical ID Theft

By | 2019, Coding and Auditing
Medical ID Theft Nicholas Goodwin, Esq. This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. Medical ID Theft "So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August...
Read More