Healthcare Practice Advisor Blog

This is the place to turn to for physician practice-specific how-to-articles to help you overcome the top challenges you face in medical coding & billing, compliance, credentialing, practice management, HIPAA, and more.

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COVID Leave: Check This Before Discharging Employee

QUESTION: A staff member has been off for more than a total of 12 weeks. She has been providing doctor’s notes that state due to her health conditions she should not report to work due to COVID-19. She was paid for 12 weeks and now is being paid from her PTO. How much more flexible can we […]

Published Date: September 18, 2020

6 Pay-Up Winning Contract Renegotiation Tactics

You can increase how much your third-party contracts pay. But it’s not easy. Insurers won’t help you to the money that’s just waiting on the table. And you may lack the confidence and experience to overcome their sneaky contract reimbursement reduction strategies. To renegotiate a payer contract that protects your practice’s profits, follow these tips: […]

Published Date: September 17, 2020

Ace Telehealth Audits and Keep Your Reimbursements

Important: Your CPT codes 99201-99215 claims are under attack. CMS and private payers started their telehealth exam post-payment audits which include reviewing your records and contacting your patients. Address these telehealth audit targets right now so you can hold onto more of your office visit pay and prevent future compliance penalties. Telehealth Exams Must Include […]

Published Date: September 15, 2020

5 Steps Pinpoint Your FFCRA Compensation Obligations

QUESTION: We are trying to figure out when and if we need to pay employees who are unable to come to work due to coronavirus related childcare and school issues. While we want to be compassionate and understand the challenges staff are facing, it’s very hard for us to operate when too many employees are […]

Published Date: September 3, 2020

CMS Rule: Prepare for Huge 2021 E/M Code Changes

You’ve been anticipating the CPT 2021 E/M coding changes and holding your breath on whether your payers will follow suit. Now with the 2021 proposed Medicare Physician Fee Schedule you can count on at least your MAC to align its coding and payment rules with AMA’s rehauled guidelines. The updates will shake up your E/M […]

Published Date: August 26, 2020

HHS Relief Fund Reporting Update: 5 FAQs Help You Keep Your Money

You suspected that the government money you accepted from the HHS Emergency Relief Fund came with strings attached but you may not have realized how hard grasping the details would be. Your practice could be one of the many new ones that has mandatory reporting requirements based on a new HHS August notification. Find out […]

Published Date: August 25, 2020

3 Steps to Determine COVID-19 PPE Requirements for your Practice

QUESTION: We are very confused about which COVID-19 PPE requirements our practice should follow. We are an ophthalmology practice, and we don’t allow symptomatic patients to come in. Should we still mandate that some or all of our staff wear masks? How about our front desk staff that just check patients in and out? Question […]

Published Date: August 19, 2020

2021 Medicare Physician Fee Schedule Telehealth

2021 CMS Fee Schedule Proposes 5 Telehealth Changes

Your telephone, telehealth exam, and virtual check-in pay could come to a grinding halt unless you’re up to date on the latest potentially upcoming changes to the 2021 Medicare Physician Fee Schedule. Auditors will be checking to see if you tightened your regulations for coding, compliance and more. Prep your practice now on the top […]

Published Date: August 17, 2020

OCR Alert: Beware of HIPAA Fraud Scam

QUESTION: We received a postcard in the mail notifying us of a mandatory HIPAA compliance risk assessment from the Secretary of Compliance, HIPAA Compliance Division. What caused our practice to be scrutinized and how should we respond? Question from San Francisco, California subscriber ANSWER: Unfortunately – or fortunately, you have been the target of an […]

Published Date: August 13, 2020

Is an ABN Mandatory or Voluntary? Here are 4 Clues to Decide

The Medicare Advance Beneficiary Notice (ABN) form is only one page long, but accurately completing the process can be as tedious as waiting for the repair man to show up. And it’s really critical that you take the time to get each step right, or you’ll be faced with increased write-offs and could even land […]

Published Date: August 12, 2020