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All Blogs

All Blogs

Patient billing

When Can You Charge Patients After Insurance Denials?

It’s a common occurrence at medical practices: You submit a claim to the insurer and in return, you get a denial. You don’t want to absorb the cost of the service you’ve already provided, so your next step is to determine whether you can bill the patient directly. While patient billing may be a complex […]
Published Date: September 12, 2023
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Insurance appeals

Master the Insurance Appeal Timeline to Fight Payer Denials

Working in healthcare is stressful enough without having to track your appeals on the calendar — but staying on time and meeting appeal deadlines will be essential if you want a strong chance of payers reversing their denial decisions. Your best bet in setting up your insurance appeals for success will be to make sure […]
Published Date: September 11, 2023
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Urine drug testing

3 Compliance Tips to Follow When Billing Urine Drug Testing

Because urine drug testing (UDT) codes don’t bring in massive reimbursement on a per-claim basis, many practices think the OIG isn’t paying much attention to these services — but that misconception can get you into trouble. In fact, the OIG frequently comes after practices that incorrectly report drug testing services, not only asking for refunds, […]
Published Date: September 5, 2023
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How long should providers keep eobs

EOB Retention Laws: How Long Must You Keep Them?

Your practice has researched how long to retain medical records, imaging scans, patient correspondence and tax forms. But have you ever wondered how long should providers keep EOBs? The explanation of benefits you receive are a valuable part of your files, but many practices wonder if it’s essential to hang on to them for long […]
Published Date: September 4, 2023
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Healthcare data breaches

3 Trends in Healthcare Data Breaches – And How to Avoid Them

A review of the government’s most recent stats about healthcare data breaches reveals a bit of both good news and bad news. On the plus side, there have been fewer data breach attacks on US health care providers and systems so far in 2023. But the bad news is that when attackers strike, they breach […]
Published Date: August 29, 2023
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Reverse false claims

How Reverse False Claims May Land Your Practice in Hot Water

As most medical practices are aware, the government is the largest healthcare payer in the United States, and the country works hard to protect the funds that go out to pay for medical services and procedures. One way that goal is achieved is through the False Claims Act, a law that allows the government to […]
Published Date: August 28, 2023
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Employee handbook

Update Your Employee Handbook, Comply With New NLRB Rule

If your medical practice’s employee handbook was written more than a month ago, it’s probably time to update it. Why? Because the latest National Labor Relations Board (NLRB) ruling has turned the employee handbook rules upside-down, requiring you to use new language if you want to stay on the right side of the law. Get […]
Published Date: August 23, 2023
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JZ modifier

Avoid Oct. 1 Denials: Report Modifiers JW and JZ Properly

When CMS debuted the JZ modifier last November, the agency gave practices until July 1 to start using it, allowing for a brief period so billers could get to know how the modifier worked. Unfortunately, some practices aren’t yet using modifier JZ, which could mean trouble starting in October—at which point Medicare payers will start […]
Published Date: August 22, 2023
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Time-based coding

9 Things You Can Count Toward E/M Time (and 4 You Can’t)

When the office-based E/​M coding guidelines changed in 2021, coders faced a huge learning curve. It involved transitioning from selecting the right code based on history, exam and medical decision making (MDM) to choosing the most appropriate code based on either time spent or MDM only. And while coders have weathered the change by now, […]
Published Date: August 16, 2023
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ChatGPT

5 Possible Healthcare Compliance Risks From Using ChatGPT

Whether you’ve spent hours learning ChatGPT or you’re just dipping your toe into this relatively new artificial intelligence technology, one thing is clear: ChatGPT is probably being used somewhere in your medical practice, and it could be putting you at risk of compliance problems. Why? Because even if it’s helpful in filling out charts or […]
Published Date: August 15, 2023
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