Artificial Intelligence is Coming to Medicare Audits

Artificial Intelligence is Coming to Medicare Audits – Is Your Legal Team Obsolete?

Published: Mon, 10/14/19

Artificial Intelligence is Coming to Medicare Audits – Is Your Legal Team Obsolete?

AI presents an entirely new landscape for defense against audits. The Trump administration has launched a program to employ artificial intelligence (AI) in Medicare audits. Use of AI will make obsolete current legal strategies leveraged when defending providers.

‘Prescribing’ DME for patients and durable medical equipment coding

Patients come to your office looking for answers to their pain or lack of function. It’s critical that a doctor doesn’t do what one of my clients admitted to recently…“X-raying the patient’s wallet.” Your patients both deserve and expect your best recommendations. If you provide...

Looming medical billing and coding changes in healthcare policy

A change in government payment policy for dermatologists and other physicians in selecting office coding and billing for evaluation and management (E/M) is scheduled to begin January 2021.

Developing a Hospital Claim Validation Strategy to Prevent Denials

The time to strengthen hospital compliance programs through claim validation is now. According to healthcare finance and information management leaders surveyed by HIMSS Media, clinical documentation and coding were the revenue cycle processes most vulnerable to errors...

Hospitals support medical billing changes, opioid payments

Hospitals support the CMS' proposed changes to medical billing coding and new payments for opioid treatment programs, but they're worried that changes to quality measures could hurt providers.

AHA Urges CMS to Abolish Site-Neutral, 340B Payment Cuts in OPPS

The American Hospital Association (AHA) questioned the legality of site-neutral and 340B payment policies in the Outpatient Prospective Payment System (OPPS), arguing the proposals would “have a chilling effect on beneficiary access to care while also increasing regulatory burden.”

The Demand for Medical Coders Is on the Rise. Here’s How to Land a Gig

After two years of following a doctor around the office as a medical assistant, Raina Diaz was ready for a change.

“I wanted to be part of the back end of the medical field,” says Diaz, 47, of St. Petersburg, Florida. She enrolled at her local state college, where she learned that becoming a medical coder could...

Medicare Retires G Codes for Mammograms

October is Breast Cancer Awareness Month. Make sure your practice’s medical coding for preventive screening mammograms is up to date with current guidelines. The Centers for Medicare & Medicaid Services (CMS) has caught up to the industry and now recognizes the...