Last fall, I wrote a blog on providers who continue to bill cost-sharing co-payments to “dually eligible” (Medicare/Medicaid) patients. This practice is not allowed; providers and suppliers are barred from […]
Being familiar with the healthcare industry has proven most valuable over the years. However, it is also a curse. We are expected to react to certain situations that others take […]
Staying current with the CMS Quality Payment Program is essential for providers. My previous blog—provided an overview of the program; then, on June 20, 2017, CMS announced changes that represent […]
Donna Smith of 3M Consulting Services explores crucial oversight processes, audit techniques, escalation policies & 2017 ICD-10-CM guidelines.
As usual I have a song in my head and this month is no different (rock ‘n’ roll tunes are so catchy)! As we are about to navigate through uncertain […]
In case you were on vacation and missed it, on August 6, 2016, Congress enacted the Notice of Observation Treatment and Implication for Care Eligibility Act. The CMS announcement regarding […]
Congress passed MACRA in a bi-partisan (yes it actually can happen!) effort. The Center for Medicare and Medicaid Services (CMS) released the 900-page proposed rule on April 27, 2016, requesting […]
MIPS is coming and physicians are unsettled. Programs with the best of intentions can have unintended side effects. Healthcare providers across the U.S. have justified complaints regarding the multiple reporting […]
I was catching up on regulatory reading today (yes, reading CMS regulations is part of my job responsibilities) and saw something troubling—providers are still balance billing qualified Medicare beneficiaries (QMBs, […]
Seems little in health care is straightforward. An area that I’ve often found confusing has become even more complex: Accurately reporting medical devices. To meet CMS regulations, not only do […]
Exploring changing quality programs with Christine McNamara, Program Director for Coding Services at 3M HIS and Melody Mulaik, President and Co-Founder of Coding Strategies, Inc.
I have always wondered why the reimbursement for services provided at a Provider-Based Clinic (PBC) was higher (often more than 50 percent higher) than the same services provided at a […]