Federal healthcare oversight authorities have announced that they are expanding their “revocation and denial authorities” in an effort to enhance their efforts to fight waste, fraud, and abuse in the American healthcare system – marking a move all but guaranteed to trouble providers already concerned over...

As you may be aware, the proposed Medicare Physician Fee Schedule (MPFS) rule for 2020 was officially published on Aug. 14, 2019. There are many components to the rule, including a proposed change in the PFS conversion factor to $36.09, the addition of several new HCPCS codes for...

A recent AMA study found that in 2018, for the first time, employed doctors outnumbered those that owned, or had an ownership stake in, a practice. For independent practices, this milestone highlights the importance of operating as efficiently as possible. That’s because financial difficulties are among the...

Poor healthcare IT infrastructure has contributed to patient care problems at Indian Health Service (IHS) hospitals, concluded a recent report by the HHS Office of Inspector General (OIG). The report found that the IHS had insufficient healthcare IT infrastructure to maintain quality assurance and monitoring at its hospitals.

The new Patient-Driven Payment Model, or PDPM, makes radical changes to the Medicare payment model for nursing homes. One of the largest changes is the reimbursement rate for services provided to HIV and AIDS patients.

Care coordination and planning are becoming increasingly important to caring for the millions of Medicare beneficiaries suffering from two or more serious health conditions, such as diabetes and heart disease. But many providers believe that current Medicare billing codes do not reflect the resources needed to provide such care.

When your job is converting medical documentation into codes, your knowledge of medical anatomy has to be shipshape. But you’ve got the added complication that the code set you’re using may have its own definitions for specific terms. Case in point: CPT^® guidelines set out five major coronary arteries with coronary artery branches...

Recently got an opportunity to interact with a few life sciences students. That is when I asked a student who seemed keen about getting into the pharma industry: “What if you don’t get your desired job profile”? This question actually was a bolt from the blue as he was baffled and realized he didn’t have a plan B.