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Provider enrollment and credentialing

3 Provider Enrollment Barriers and How to Overcome Them

One of the simplest and fastest ways to keep reimbursement flowing at your practice is to ensure your provider enrollment and credentialing processes never face any hiccups. After all, if you don’t get your providers enrolled and credentialed swiftly, they could be terminated from payer networks and dropped from hospital admitting rolls. Plus, you’ll be […]
Good faith estimates

Keep These Timelines in Mind for Your Good Faith Estimates

Creating compliant good faith estimates for self-pay and uninsured patients means more than just handing patients a form with a number on it. You must also master the timing of the estimates you distribute—and if you don’t, the government could fine your practice. Why? Because the estimate needs to give the patient enough time to […]
Telehealth regulations

HIPAA and Telehealth: Four Essential Ways to Stay Compliant

When the pandemic first began impacting U.S. medical practices in 2020, many providers scrambled to get their telehealth systems up and running to meet the telehealth regulations. Today it’s a completely different landscape, with telehealth one of the norms in modern practices and many organizations declaring that telehealth is here to stay. Even as these […]
Chronic pain management

G3002: Make the Chronic Pain Management Codes Work for You

Medical practices have become accustomed to hearing about cuts to Medicare pay every year, so it’s always good news when Medicare begins covering a new service. Such is the case this year, now that CMS has introduced two new Medicare-specific codes covering chronic pain management. Before you can start collecting for the newly-released chronic pain […]
Evaluation and management codes

See How Coding for 2 E/M Visits on 1 Day Dramatically Changed

It’s a question that has confounded coders and practice managers for years: What do you do if you see a patient in your office, then admit them to the hospital because the condition requires more acute attention? Reporting two evaluation and management codes representing the different sites of service has not been an option in […]
LEP patient

5 Tips to Create an Effective Translation Program for LEP Patients

Communication is one of the most critical elements of good patient care, and without it, your providers won’t know the patient’s history, current complaint, or even their name. That’s one reason the government requires practices to offer free written and verbal translation services to limited-English proficiency (LEP) patients. If you don’t have a plan in […]
HIPAA

Your Comprehensive Guide to Performing Weekly HIPAA Analyses

When patients come to your practice, they expect their medical information to remain private, and it’s your job to make sure that happens. To stay on top of your HIPAA requirements, your best bet is to create ongoing, weekly and quarterly checklists that can help you remain on track with every responsibility. As a best […]
False Claims Act

4 Tips Help You Head off Employee Whistleblower Complaints

No medical practice wants to be the target of a False Claims Act (FCA) accusation. Penalties for violating the FCA include fines of up to $11,000 per claim, attorney costs, exclusion from Medicare, and having to pay back triple the damages that the government incurs. But if you want to avoid FCA accusations, your best […]
HIPAA

Check These Ongoing HIPAA Responsibilities to Stay on Track

Keeping your patients’ information private is one of the most important ways to stay compliant at your medical practice, and requires more than just signing off on forms. It requires vigilance and commitment, and that means you may need to perform a few ongoing tasks to stay on track with HIPAA compliance. As part two […]
Amending medical records

5 Tips to Remember for Compliant Documentation Amendments

Contrary to popular belief, you can sometimes make amendments to medical documentation after the date of service, as long as you know the rules. The key is to ensure you’re following payer regulations, state laws and internal compliance guidelines that your practice has in place. As long as you check those boxes, amending the medical […]