DM in the News

Nov 09 2015

Know your rights when payers try to recoup payments

By Karen DM in the News, Practice Operations

Know your rights when payers try to recoup payments Before your practice pays back any money following a recoupment demand from an insurance plan, make sure your rights are protected, and don’t fall victim to payer scare tactics. That’s the message from Thomas Force, expert healthcare attorney and president and founder of The Force Group,...

Aug 11 2015

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ICD-10 Codes and More: Interview with John Burns, Certified Professional Coder

By Karen 2015, Coding and Auditing, DM in the News

ICD-10 Codes and More: Interview with John Burns, Certified Professional Coder By John Burns, CPC, CPC-I, CEMC, CPMA | August 6, 2015 As originally published on Audiology.org Douglas L. Beck, AuD, speaks with Burns about Medicare, Congress, ICD-9, ICD-10, ICD-11, and more. Beck: Hi, John. I know you have many unusual and interesting credentials and training with...

Jul 22 2015

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Surgeon Scorecard: Comparison is the Death of Joy (Mark Tw

By Karen 2015, DM in the News, Frank Cohen

Surgeon Scorecard: Comparison is the Death of Joy (Mark Twain) By Frank Cohen, Director of Business Analytics | July 22, 2015 As originally published by Racmonitor.com Is your surgeon better than my surgeon? Even if that were true, with all the nuances involved in performing a surgical procedure and the infinite number of iterative complications that...

Jul 08 2015

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Got Docs? Hospital-Owned Physicians Post Equal Risk

By Karen 2015, DM in the News, Frank Cohen

Got Docs? Hospital-Owned Physicians Post Equal Risk By Frank Cohen, Director of Business Analytics | July 8, 2015 As originally published by Racmonitor. com In 1986, when I was in charge of physician services for a hospital in Connecticut, we were buying up physicians like crazy in an effort to control referrals and admissions to our...

Jun 17 2015

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E&M Auditing: Defining the HPI

By Karen 2015, Coding and Auditing, DM in the News

E&M Auditing: Defining the HPI By Shannon DeConda, CPC, CPC-I, CPMA, CEMC, CMSCS | June 17, 2015 As originally published by Racmonitor.com The 20-year-old evaluation and management (E&M) documentation guidelines are full of different components and elements, all of which must be reviewed in order to ensure that services billed were appropriately documented. If you...

Jun 07 2015

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The Nash Equilibrium: A Study in the Futility of Striving for Healthcare Compliance

By Karen 2015, DM in the News, Frank Cohen

The Nash Equilibrium: A Study in the Futility of Striving for Healthcare Compliance By Frank Cohen, Director of Business Analytics | June 3, 2015 As originally published by Racmonitor.com. I’m not sure how many people paid attention to the sad news over Memorial Day weekend, but Dr. John Forbes Nash Jr., a brilliant mathematician, economist, and...

Jun 05 2015

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Starting an Urgent Care Center

By Karen 2015, DM in the News, Practice Startup

Starting an Urgent Care Center by Valora Gurganious, MBA and Dan Greenfield, CDT Published in Medical Economics,| June 4, 2015 According to the American Academy of Urgent Care Medicine (AACUM), the number of urgent care facilities has increased 14% to 9,300 centers since 2008. The economics support this trend. The Urgent Care Association of America...

May 26 2015

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Using RVUs to predict compliance risk: How to do it

By Karen DM in the News, Frank Cohen, Regulatory Compliance

Using RVUs to predict compliance risk: How to do it By Frank Cohen, MPA | May 15, 2015 Conducting an internal review of your practice's work using RVUs can help predict, and perhaps ward off, a compliance audit. Here's how. Typically, healthcare professionals view relative value units (RVUs) as a way to model the business of medicine....

Apr 15 2015

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Problems with Extrapolation

By Karen 2015, DM in the News, Frank Cohen

Problems with Extrapolation By Frank Cohen, Director of Business Analytics | April 15, 2015 As originally published by Racmonitor.com To begin, I believe that the recent audit of Northwestern reflects the generally poor processes and statistical modeling used by Centers for Medicare & Medicaid Services (CMS) auditors when scrutinizing a healthcare provider. In particular, there seems...

Mar 18 2015

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Giving Clarity to the Ambiguity of E/M Services

By Karen 2015, Coding and Auditing, DM in the News

Giving Clarity to the Ambiguity of E/M Services By Shannon DeConda, CPC, CPC-I, CPMA, CEMC, CMSCS | March 18, 2015 As originally published by Racmonitor.com Evaluation and Management (E/M) services have many gray areas from an auditing standpoint, yet they continue to represent a top audit target for payers and the government. The documentation guidelines...

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Know your rights when payers try to recoup payments

ICD-10 Codes and More: Interview with John Burns, Certified Professional Coder

Surgeon Scorecard: Comparison is the Death of Joy (Mark Tw

Got Docs? Hospital-Owned Physicians Post Equal Risk

E&M Auditing: Defining the HPI

The Nash Equilibrium: A Study in the Futility of Striving for Healthcare Compliance

Starting an Urgent Care Center

Using RVUs to predict compliance risk: How to do it

Problems with Extrapolation

Giving Clarity to the Ambiguity of E/M Services

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