In an effort to reduce healthcare disparities, the American Medical Association (AMA) recently vowed to support the creation of new alternative payment models that specifically address the outcomes of high-risk and vulnerable populations. At its annual meeting on June 11 in Chicago, the industry leader adopted the following three policies...

When the Patient-Driven Groupings Model (PDGM) launches Jan. 1, 2020, leveraging tools and resources to ensure compliance will be critical to a successful transition. Home health care providers already have one helpful tool in place: the electronic health record (EHR). By incorporating workflow efficiencies...

Audits can be an unfortunate reality of practicing medicine. The good news is that as long as you are practicing and coding correctly, you have nothing to fear should you be audited. There are four main types of audits:

That’s the contention of the Department of Health and Human Services’ Office of the Inspector General. An OIG audit discovered 34,664 Medicare claims that contained diagnosis codes indicating the treatment of injuries potentially caused by abuse or neglect of Medicare beneficiaries.

There are nine different Multiple Procedure indicators on the Medicare Physician Fee Schedule (MPFS), meaning there are a lot of payment adjustment possibilities you need to know. Here’s each indicator, an example of a code with that indicator, and a quick look at where modifier 51 comes into play.

It is important to make sure medical billing companies under consideration have intimate knowledge about your specific practice. Billing codes and support documentation requirements are different for specialty services as compared to general services provided by family practitioners and PAs. It is always more...