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All Blogs

Infusion Administration

Recognize Infusion Administration Types to Ensure Proper Payment

Coding infusions is far from run-of-the-mill, and if you don’t get it right, you’ll likely see reduced — if not denied — claims. One of the key concepts when reporting this service is understanding the type of infusion you’re providing. Get it right, and your claim sails through, but get it wrong, and you’ll be […]
Published Date: July 18, 2017
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HIPAA Breaches

Protect Yourself From Vendor HIPAA Breaches, or Pay the Price

Just because you’re taking care of your obligations under the Health Insurance Portability and Accountability Act (HIPAA), doesn’t mean that the vendors you work with are doing the same. So why should you care? Because if your vendors access your patients’ confidential information through your working relationship and have a breach of that data, you […]
Published Date: July 6, 2017
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Incident-to Billing

Incident-to Means You Must Have Employment Relationship, or You Lose on Pay

Set up the wrong employment relationship with your nonphysician practitioners (NPPs), and you’ll forfeit the ability to bill their services incident-to your physicians and miss out on an additional 15% of their reimbursement. Or worse, you could bill incident-to incorrectly and get targeted for an audit and be required to pay back all the reimbursement […]
Published Date: June 28, 2017
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MACRA Proposed Rule

MACRA Proposed Rule Could Make MACRA Compliance Easier for Small Practices

If the pending proposed Quality Payment Program (QPP) rule released Jun 20th is finalized later this year, it will be easier for small physician practices (defined at 15 or few eligible clinicians) to earn automatic bonus points and earn hardship exemptions due to electronic health record (EHR) requirements. The currently approved plan states that practices […]
Published Date: June 21, 2017
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CMS Makes Qualified APM Provider Lookup Available

Even though 2017 is the first year you’re required to collect and report your MACRA quality data, the question of whether you qualify for an Alternative Payment Model (APM) was still open for most providers. The benefit of qualifying to report under APM guidelines is that you don’t have to worry about getting your future […]
Published Date: June 13, 2017
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MIPS Participation Status Letter

Look for Your MIPS Participation Status Letter Soon

You should learn soon whether you meet the 2017 MIPS participation threshold, CMS announced in an April 25 press release. This means you may know sooner — rather than later — if you have to comply with MACRA for the 2017 reporting period. During the month of May, you will receive a letter from the […]
Published Date: May 1, 2017
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ICD-10 Diagnosis

Get Specific: Encounter Type Often Drives 7th Character … and Medical Necessity

When choosing the most accurate ICD-10 diagnosis code, you’re often required to include all seven characters to prove the medical necessity for a procedure or office visit. If not, your chances of having the claim denied are significantly increased. Nailing down that seventh character can be vital for getting your claims paid the first time […]
Published Date: April 25, 2017
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Front Desk HIPAA

Halt Front Desk HIPAA Check-in Violations

Each time a patient checks-in with your front desk, your risk of a HIPAA violation goes through the roof. Especially considering that patient check-in occurs over and over again, every day you’re open to see patients. You might think that your front desk staff are to blame for this increased HIPAA risk. However, the real […]
Published Date: April 18, 2017
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Chronic Care Management

Get on Board With CCM and Stop Leaving Money on the Table

Although Medicare began paying for chronic care management (CCM) services in 2016, the Centers for Medicare and Medicaid Services (CMS) reports that many practices are not taking advantage of the new coverage, even after more than a year. And if you’re not billing this service for those who are likely your sickest patients, you’re losing […]
Published Date: April 11, 2017
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