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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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.

Get these valuable articles straight to your inbox. Sign up for Healthcare Practice Advisor e-newsletter. Just enter your email in the box on the left.

PHI Medical records

Protect These Surprising PHI Examples or Risk Medical Records Fines

Breaking medical records retention and destruction rules means big-time financial penalties — up to $50,000 per violation. And while you generally recognize the most common forms of protected health information (PHI) for example patient names and addresses, you’ll be surprised by the many, many types of patient information that are subject to medical records retention […]
COVID Vaccine Admininstration Coding

Get the Correct COVID-19 Vaccine Administration Code and Pay

You MUST use a totally different system to get paid and code for COVID-19 vaccine administration; unlike other vaccines that use generic administration CPT codes, coronavirus vaccine reporting requires unique codes. Get up to speed now on the available vaccines and how to report them correctly from your very first claim without over billing. There […]
coordination benefits

Coordination of Benefits: Reduce Payment Delays with Six Simple Steps

QUESTION: We experienced an increase in Coordination of Benefits (COB) issues with Medicare last year. We finally found out there was a “glitch” in their system. The previous accident claim information was populating the primary insurance field. It took us quite a while to recover from this. What can we do to avoid issues like […]
PPP Round 2 Funding Application

PPP Round 2 Funding: Get Much-Needed Money with Application FAQ

Your new year’s gift is here; the government is offering you additional relief money to cover your coronavirus prevention, preparation and response costs. The Consolidated Appropriations Act, 2021 includes a second round of the Paycheck Protection Program (PPP) funding with another $284 billion up for grabs. But with a short deadline, your chance for securing […]
HHS Reporting Deadline

HHS Reporting Deadline: Keep Your Funds with Must – Follow Accounting Rules

You MUST file your HHS Provider Relief Funds report by the February 15 deadline or you’ll have to pay back your much-needed money. Report an unallowed expense or the wrong amount and you won’t be able to keep your funds. HHS keeps issuing updated guidance on the CARES Act Provider Relief Funding including reporting requirements, […]
2021 prolonged services changes

2021 Changes: Get $20 for New Prolonged Service Codes

2021 prolonged services codes help you capture additional reimbursement for the extra time you spend with time-intensive patients, but you must meet all the requirements to correctly bill the added minutes, or you’ll face denials and be forced to hand over your much-needed pay. IMPORTANT: CMS assigned values to a new Medicare only prolonged service […]
2021 E/M MDM Guidelines Data

2021 E/M MDM Guidelines: Justify Data Score, Correctly Credit Tests

You can get more credit towards higher levels of medical decision making (MDM) using 2021 E/​M data guidelines that allow you to give more points for tests that your provider orders and/​or reviews. The money is just waiting for you to take it. Getting paid accurately for your office visits in 2021 hinges on your […]
2021 Stark Exceptions

2021 Stark Exceptions: Stop Violations for Your Self-Referrals (Jan 19 Deadline)

Your referrals, value-based arrangements, and physician compensations can land you with huge penalties unless you meet all of the 2021 Stark Law requirements that go into effect January 19th. Make just one error, and you’ll be fined $25,000-$50,000 per violation – you can even be excluded from Medicare and Medicaid. CMS and OIG have made […]
COVID Post Travel Employment Laws

Head Off COVID-19 After Travel Employment Law Violations

QUESTION: Some of our employees are planning on traveling out-of-state during the holidays. We are considering restricting their vacations to reduce the post-travel risk of them spreading the coronavirus to our staff and patients. If they do travel, can we require an after-travel quarantine before we allow the individual to return to work? Question from […]
2021 E/M Guidelines for medical decision making

Avoid Pay Loss from 2021 E/M Guidelines for Medical Decision Making

The new 2021 E/​M coding guidelines give you the option of using either time or medical decision making (MDM) to choose the proper code level for office visits. And while time-based coding may be simpler, it’s not always the best choice. Solely follow the clock, and you could cheat yourself out of valuable reimbursement. Three […]
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