Documentation Checklist Bulletproof Your Claims

Documentation Checklist Can Bulletproof Your Claims

Provider documentation is your only defense if you’re faced with an audit. It must be rock-solid to support the claims you submit to payers. But how can you ensure this happens when each clinician has his or her own style and perspective when documenting a patient encounter? The answer is good basic, defensible documentation. Here […]
Incident-to Billing

Incident-to Means You Must Have Employment Relationship, or You Lose on Pay

Set up the wrong employment relationship with your nonphysician practitioners (NPPs), and you’ll forfeit the ability to bill their services incident-to your physicians and miss out on an additional 15% of their reimbursement. Or worse, you could bill incident-to incorrectly and get targeted for an audit and be required to pay back all the reimbursement […]
Ortho Management

Ortho Management (97760) Billing

Can an orthopedic practice bill for orthotic management? One of the most commonly asked question is, “Can I bill 97760?” If you are an orthopedic practice, you really can’t. This is because it should always be a therapy service, and it has to be under a therapy plan of care. If your physician asks an […]
60-Day Rule Timeline

Avoid Tripping Over the 60-Day Rule Timeline … Know When to Start the Clock

The relatively new 60-Day Rule affects all Medicare and Medicaid providers regardless of specialty, size or type, and nailing down the exact date to begin your 60-day countdown is one of the most confusing compliance aspects — although other rule components can easily trip you up as well. The rule may seem straightforward — you […]
Medicare Overpays

Medicare Overpays Billions on E/M Claims

According to a May 2014 report based on 2010 data, HHS is claiming Medicare overpaid $6.7 billion in E/​M payments to providers. The Inspector General’s report, released on May 29, 2014 estimates that 21% of the $32.3 billion spent on E/​M services in 2010 are overpayments.  This data is based on 657 Medicare claims. Although […]