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How to Update Your Telehealth Security With the PHE Over

As most practices are aware, the COVID-19 public health emergency ended on May 11, 2023, and with it came the end of relaxed HIPAA rules for providers meeting with patients over telehealth. The Office of Civil Rights (OCR) has given providers a 90-day flexibility period to ensure telehealth systems and practices are in line with […]
Chronic pain

G89 Series: How to Select the Best Chronic Pain Diagnosis Code

When CMS introduced chronic pain management codes G3002 and G3003 effective Jan. 1, practices rejoiced at the new options. But coverage for these codes, as is the case with all medical claims, hinges on medical necessity. And the best way to demonstrate that is to report the most accurate ICD-10-CM codes. To correctly identify the […]
Patient referrals

3 Ways to Spot Potentially High-Risk Patient Referrals

The government maintains a very broad definition of “referrals,” which means practices have to work harder than ever to avoid Anti-Kickback law violations. Every time you refer a patient somewhere, you’ve got to have your eye on whether it’s a compliant referral to avoid accusations of wrongdoing. One way to stay on the straight and […]
Evaluation and management

Report Reveals Whether E/M Changes Freed up Provider Time

When the CPT rules changed in 2021 and the evaluation and management (E/​M) coding requirements were overhauled, one of CMS’ goals was to cut back on the documentation burden that providers faced. By choosing E/​M codes based on time or medical decision making (MDM) for outpatient visits, the idea was that providers would have more […]

Introducing a New LOOK for Your On-Demand Training Access …

Effective Tuesday, May 30, accessing your on-demand training(s) will have a whole new look and feel. We hope this new design will make it easier for you to navigate to your on-demand video recording, as well as access related training materials, such as the presentation handouts. See below for more details on these changes going […]
Modifier 25

Cigna Delays Plan Requiring Medical Records With Modifier 25

UPDATE: Cigna has delayed the requirement described below, and it will no longer take effect on May 25. The company has not yet indicated when it will go into place, so keep an eye on the Healthcare Training Leader website for more information as this story develops. When you perform a minor procedure along with […]
Doctor pay

Report: Medicare Physician Pay Down 22% in Last 20 Years

When most businesses look to the future, they envision income and revenue rising incrementally over time, and medical practices are no exception. However, the results of a new survey show that when adjusted for inflation, Medicare physician pay dropped 22 percent between 2001 and 2021. That’s the word from the 2023 Physician Compensation Report by […]
Medication management

When You Can Bill 99605 for Rx Refills (and 4 Times You Can’t)

When patients need new or updated prescriptions, your provider probably puts a lot of work into ensuring that they get the right medications. In these situations, there may be occasions when you can bring in reimbursement for medication management using codes 99605-99607. Find out when this is an option and when it isn’t. When You […]
stark law

Discover How the PHE’s End Will Impact the Stark Law

The end of the COVID-19 Public Health Emergency (PHE) is now behind us, and the discontinuation of certain PHE policies spans far beyond COVID-19 tests and vaccinations. In fact, the PHE’s end also has compliance considerations that every practice must know. Among these are vast changes to the Stark law and the ending of blanket […]
Prior authorization

How Medicare Advantage Prior Authorization Will Change in 2024

If your practice is like most, you’ve faced myriad headaches dealing with Medicare Advantage (MA) denials. In some cases, even when MA plans approve prior authorizations for certain services, you end up facing denied claims. Thanks to a new rule, however, that issue should go away in January. Background: On April 5, CMS issued a […]