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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Prevent Practice Theft & Fraud by Using Healthcare Background Checks

Because your healthcare practice is subject to strict regulations and privy to sought after data, you can’t afford to hire a risky candidate. A compliant healthcare background check is just what you need to screen applicants, verify their credentials, and reduce your financial liability. Pick the Right Types of Healthcare Background Checks You Need Companies […]

Published Date: January 17, 2020

5 Steps Make Financial Waivers a Good, Not Risky Deed

QUESTION: We serve a large volume of underprivileged patients who can barely afford to eat. Our doctors often want to help them by waiving their deductibles and co-pays. Could we get in trouble for doing this “good deed”? Cookeville, TN Subscriber ANSWER: Waiving a patient’s co-pay, deductible, or co-insurance can put your practice at risk […]

Published Date: January 16, 2020

Carrot or Stick: Immunization Laws for Healthcare Workers

As the flu season kicks into high gear, healthcare organizations are grappling with the reality that not all their employees are willing to roll up a sleeve and accept an influenza immunization — or any other vaccine for that matter. The big question is: Can you require your staff to get vaccinated? The answer is […]

Published Date: January 14, 2020

Provide Timely Medical Records or Risk $85K HIPAA Penalty

You must be vigilant in timely releasing patient medical records or face $85,000 in penalties. That’s the amount fined to the second group this year. In December, Korunda Medical, LLC in Florida was fined $85,000 for slow-walking a patient’s medical records. This is the second enforcement action and settlement leveraged by the Office for Civil […]

Published Date: January 10, 2020

2020 CMS Telemedicine: Bill More Services From Eased Locale Rules

The recently released 2020 CMS Telemedicine Policy Final Rule’s changes just went into effect on January 1. Topping the list of improvements are new HCPCS codes, greater flexibility with telehealth location, and more telehealth benefit options. Count Home as Originating Site and 2 Other Sweeping 2020 CMS Telemedicine Changes This major final rule revises payment […]

Published Date: January 7, 2020

Keep 60% Pay by Acting on Medicare Advantage Overpayments by Feb

If your physicians participate in Medicare Advantage Plans, keep a sharp eye on the mail. The final Medicare Advantage Overpayments letter is being mailed to practices the first week of January, and it contains a time-sensitive CMS settlement offer that you must act on this Winter or risk significant financial losses. Medicare Advantage Overpayments Letters […]

Published Date: January 3, 2020

Does Medicare Fee Schedule Include E/M Changes for 2020?

QUESTION: I’m pretty nervous about the significant changes to the Evaluation and Management (E/M) codes being made soon. The 2020 CMS Physician Fee Schedule goes into effect January 1, 2020, Does it contain the changes? ANSWER: The 2020 Medicare Physician Fee Schedule Final Rule confirms that the E/M code changes completely take effect in 2021. […]

Published Date: December 31, 2019

Speed Up Doctor’s Hospital Privileging

QUESTION: Our providers have privileges at two separate hospitals. Every couple of years, they make us jump through a variety of hoops to keep our providers’ hospital privileges active. This year, one of the hospitals is asking us to send provider references. Who should we ask? Anonymous, Alpharetta, GA ANSWER: Hospitals typically ask for three […]

Published Date: December 26, 2019

Don’t Lose $64 Per CPT 99201-99215 Office Visits for New and Established Patients

Determining whether a patient is new or established shouldn’t be complicated — but coding CPT 99201-99215 office visits is oftentimes not so clear. Miscoding these E/M visits, however, can cost you thousands of dollars each year in lost revenue. In fact, selecting an established patient when you should have billed a new patient office visit […]

Published Date: December 23, 2019

4 Must-Know Injection and Infusion Tips to Boost Pay Up

Correctly coding for injections and infusions can often feel like a shot in the dark. From assigning codes for multiple drugs to add-on codes to accurately documenting stop and start times, even the most experienced coders feel the pinch of these complex coding guidelines. But code claims incorrectly, and you could be costing your practice […]

Published Date: December 19, 2019