Healthcare Practice Advisor

Here you’ll find practice-specific articles to help you overcome the most common challenges you face in areas such as medical coding billing, compliance, credentialing, practice management and more. If you’d like to receive these valuable articles in your inbox, it’s free to subscribe to the Healthcare Practice Advisor e-newsletter. Simply enter your email address to the left to sign up.

Practice QA: Derail HIPAA Violations When Leaving Patient Messages

QUESTION: I’m trying to prevent staff from making costly HIPAA violations when they leave patient voice mails. What should and shouldn’t you say when leaving voice messages for patients? Anonymous, Chicago, IL ANSWER: To avoid HIPAA violations, first, it’s important that you have a signed consent form on file for all of your patients. […]

Published Date: November 15, 2019

CMS 2020 Chronic Care Management Changes Ease Billing, Care Plan

Meet 5 Capabilities for Chronic Care Management Billing – CMS 2020 Eases CCM Reporting Do you often treat patients with chronic conditions? If you’re like most providers, the answer is yes. Whether it’s diabetes, arthritis, or heart disease, an increasing number of your patients are likely to have at least one chronic condition, especially as […]

Published Date: November 13, 2019

2020 Medicare Physician Fee Schedule: TCM Expands, E/M Confirmed

If you don’t have time to comb through the 2020 Medicare Physician Fee Schedule Final Rule, you’re not alone. Most physicians and staff are simply too pressed for time to figure out exactly what parts of the rule are relevant to their practice and specialty. If that’s the case — don’t worry. We’ve sussed out […]

Published Date: November 8, 2019

Can Primary Care First Model Boost Your Pay?

If you are a primary care provider who treats Medicare patients — and looking to increase your revenue — the Primary Care First model might be just what you’re looking for. Earlier this year, CMS announced its Primary Cares Initiative, consisting of two new Alternative Payment Models (APMs). Both qualify as Advanced APMs for participation […]

Published Date: November 8, 2019

CDC Notice: 4 Rules for ICD-10-CM Vaping Coding

Due to the epidemic of vaping related injuries and deaths, the CDC has released ICD-10-CM Vaping Coding Guidance. Based on what is now known about vaping or e-cigarette-related health conditions, the update contains official diagnosis coding guidance for encounters related to e-cigarette or vaping product use associated lung injury (EVALI). The CDC is investigating the […]

Published Date: November 7, 2019

6 Tips for Successful Third-Party Payer Appeals

When even the slightest mistake on a claim form can lead to a denial or reduced reimbursement, you need to be on your toes. The good news is with some leg work third-party payer appeals can get you paid more of what you are due. While third-party payer appeals are a time-consuming complex process, they’re […]

Published Date: November 1, 2019

OIG 2020 Watch List: Urine Drug Test & SLP Claims Drive Audits

The Office of Inspector General (OIG) October 2019 reports added to its Workplan items that contractors will audit or evaluate with a more critical eye. If you bill for urine drug test or speech-language pathology services to Medicare beneficiaries, now’s the time to weigh your compliance risk and fix any issues. OIG 2019 Adds Urine […]

Published Date: October 31, 2019

CMS New Rule: Stark Law Promotes Care Over Self-Referral

The 80’s are back, but it’s not fashion you should worry about. First enacted in 1989, the Stark Law is getting significant updates from CMS that benefit patient care, according to a proposed rule issued in October 2019. Comply with these new regulations that open the door to areas previously restricted as conflicts of interest. […]

Published Date: October 30, 2019

Legal Column: 3 HIPAA Compliance Cases Giving Attorney Nightmares – Heidi Kocher, Esq

There’s a lot at stake if healthcare professionals don’t comply with HIPAA and other government regulations. No one knows this better than myself – a healthcare attorney. The relationship between healthcare attorneys and the practices we serve is a paradox. On the one hand, the healthcare attorney is viewed as the institution’s life raft — […]

Published Date: October 29, 2019

6 Steps Maximize Reimbursements for Well Woman Exam Claims

October is Breast Cancer Awareness month, and research shows that early detection leads to better outcomes. That’s good news for patients! Unfortunately for physicians, getting reimbursed for preventive well woman exam claims is sometimes a challenge — not all insurers and payers reimburse for these services and the coverage rules vary for the payers who […]

Published Date: October 24, 2019