A “bold proposal” to reduce the documentation burden on physicians was released as part of CMS’s 2019 proposed Medicare Physician Fee Schedule (PFS). This seemed to have begun as an effort to listen to stakeholders and address the problems of out-of-date guidelines, cloning...

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.

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...

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.

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 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.

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.”

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...