July 2013 - revMD

Is your Radiation Oncology Coding Compliance being Taken Seriously Enough? 10 Questions to Ponder

Is your Radiation Oncology Coding Compliance being Taken Seriously Enough? 10 Questions to Ponder

sam-mi2013-07-23T09:44:02+00:00

If an OIG investigator were suddenly to appear on your Radiation Oncology practice's doorstep, would you be prepared for the scrutiny? You may very well be waving compliance red flags in your Radiation Oncology revenue cycle management—and not even know it—that send messages your compliance is not being taken seriously enough. It's time to take a hard look around your work environment and review the 10 telltale signs in a list provided by Robert A. Pelaia, Esq., CPC, CPCO. Each sign indicates to investigators they should delve deeper in your compliance activities. Note these are in no particular order: 1. Patient [...]

Is your Radiation Oncology Coding Compliance being Taken Seriously Enough? 10 Questions to Pondersam-mi2013-07-23T09:44:02+00:00

Assured Return Offers Medical Practice Billing Advantage and Mitigates Healthcare Risk

Assured Return Offers Medical Practice Billing Advantage and Mitigates Healthcare Risk

sam-mi2013-07-19T09:22:30+00:00

"At risk." Two words that might just make you think twice about the practice of medicine. But once you know what the biggest risks are to your medical practice and how to mitigate them, you'll actually have the advantage. Risks for medical practices and physician medical billing are continually evolving. Growing numbers of regulations (12,000 and counting in the new Affordable Care Act alone), concerns over the increasing cost of healthcare and new technologies expose you and your patients to greater risks. Examples of some of today's biggest risks include: HIPAA Audits Fraud and abuse Identity theft Other compliance issues Compliance [...]

Assured Return Offers Medical Practice Billing Advantage and Mitigates Healthcare Risksam-mi2013-07-19T09:22:30+00:00

Seeing Red? Tips for Better Coding Help Stop the Bleeding, Increase Control of Radiology Revenue Cycle Management

Seeing Red? Tips for Better Coding Help Stop the Bleeding, Increase Control of Radiology Revenue Cycle Management

sam-mi2013-07-16T10:43:38+00:00

Did you ever think the words "hemorrhaging" and "vulnerable" would pertain to your radiology coding and billing? More than likely, they do. That's because your healthcare revenue cycle management is actually more susceptible to errors which, when you add them up, can cost as much as a full time radiology coding professional on average. It's a fine line radiologists walk every day. Under-coding leads to lost revenue, while over-coding threatens compliance. The most common challenges stem from either inadequate documentation, which leaves coders without all the details necessary to maximize radiology reimbursement, or incomplete knowledge of latest coding practices. Poor and [...]

Seeing Red? Tips for Better Coding Help Stop the Bleeding, Increase Control of Radiology Revenue Cycle Managementsam-mi2013-07-16T10:43:38+00:00

Claim Denial Again: Why Your Urology Medical Coding and Billing are at Risk

Claim Denial Again: Why Your Urology Medical Coding and Billing are at Risk

sam-mi2013-07-11T09:00:16+00:00

Few things are more frustrating than providing care to a patient expecting fair payment in return, only to be informed that your Urology medical practice coding and billing claim is being denied because the payer doesn't think the service was medically necessary. You've ensured your revenue cycle management process is up to speed, or so you think. Yet, you're still faced with a good percentage of denied insurance claims. And it's beginning to affect your bottom line because your medical practice reimbursement is taking a hit. What's going on? While there are plenty of reasons an insurer might deny your claims, [...]

Claim Denial Again: Why Your Urology Medical Coding and Billing are at Risksam-mi2013-07-11T09:00:16+00:00

Medical Necessity for Joint Replacements Requires Heightened Orthopedic Medical Coding Documentation

Medical Necessity for Joint Replacements Requires Heightened Orthopedic Medical Coding Documentation

sam-mi2013-07-09T09:49:23+00:00

How often are you faced with denied claims for joint replacements or those slow to be reimbursed because medical necessity is being reviewed or questioned? One of the most challenging aspects of your orthopedic surgery practice these days is when you provide a service to a patient who genuinely needs a joint replacement only to find later that reimbursement has been denied. Substantiating the need for joint replacement surgery requires detail, detail and more detail in order to avoid claim denial and keep your orthopedic revenue cycle management flowing smoothly. The following CMS guidelines are provide to help you avoid claim [...]

Medical Necessity for Joint Replacements Requires Heightened Orthopedic Medical Coding Documentationsam-mi2013-07-09T09:49:23+00:00