The below articles are all published in BC advantage
Magazine and written and contributed by Sean
Weiss
Sean Weiss Partner and Vice President of Compliance
at DoctorsManagement LLC
Knoxville, TN
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Modifier 57 with E/M Question
I have been using modifier 57 with E/M when decision for surgery has been made, this could be between 2weeks before the surgery to 1 day before the surgery. A co-worker went to a meeting and they told her to only use modifier 57 when the office visit...
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Split/Shared Visits - Q and A
I read your article "Split/Shared Visits" and found it to very helpful . We recently added a PA to our surgical office and the rules for PA billing are extremely confusing and many times contradictory by payor. And the recent change by Michigan BCBS ...
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Global post-op - Q and A
I work at a provider-based facility. A physician has recently become employed at our facility after working for the other facility in the city. While at the other facility, he performed multiple surgeries on patients that he is now seeing in post-op ...
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Split/Shared Visits
After spending so much time working with mid-level practitioners around the country in both inpatient and outpatient hospital settings it became obvious to me that there is a lot of misunderstanding regarding how Split/Shared Visits work. A lot of ar...
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Wishing Someone Special Well
Normally, I write about coding/billing, compliance and practice management issues but I wanted to put that all aside this week and tell you about a very special person that a lot of us in our industry respect, depend on and consider a good friend. Th...
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Revising The Medicare ABN - What it Means to You
Recently CMS decided to revise their CMS 141G form (better known as the ABN). One of the main changes you will notice is that it is now referred to as the Advance Beneficiary Notice of Noncoverage, which was done to more clearly convey the purpose of...
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Back to Basics in 2008:
Here we are in the beginning of another year ready and eager to take on the world of reimbursement. We have been armed with all of the changes for CPT®, ICD-9-CM, HCPCS II, etc... but how many of you are truly ready to take on the insurance carriers ...
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Tips for getting reimbursed
For years and years we have worked with providers on this particular topic. No matter how many times we write articles about it or provide a written guidance to one of our clients we still find we are asked tons of questions about his tricky situatio...
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Increasing Collections and Reducing Denials
As an industry I believe we are struggling and we will continue to struggle with the collections from patients and insurance companies until we realize how we need to go about doing it the right way. I personally believe 80% (if not more) of medical ...
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Charging for Medicare NO SHOWS - It is Finally in Black & White
To charge or not to charge, that is and has been the question for years when it came to Medicare patients who missed their appointments. There has never really been anything in writing to say one way or the other until now. The Medicare Claims Proces...
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Expert Witnesses in Coding - The End of an Industry
Today I had the displeasure of reading a deposition from an "Expert". This "Expert" is an "expert" in coding and was being brought in to testify on behalf of an insurance company regarding a case where a provider had allegedly inappropriately billed ...
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How Secure is Your Signature?
While working this past week in Texas with a client we encountered a security breach in the Electronic Medical Records System (EMR) used by our client. The breach I am referring to is that of the physician electronic signature. Here is what we found ...
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Legibility and The Medical Record
Have you ever wondered why a physician writes in such a manner that really no one on earth can read it? Over the years I have worked with more physicians then I have hair on my head and the one constant I find is the illegibility of physician handwri...
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When EMR Becomes A Compliance Risk
I had to really, really be sure I wanted to send this article to my good friends at BC Advantage before I wrote it. I must tell you this one is a struggle for me because of my ties and also my friendships with EMR companies especially our very good f...
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Medicare Beneficiary Complaints and Its Impact on You
Recently we have received a few calls from clients wanting to know what to do when a patient calls Medicare and lodges a complaint regarding clinical and quality of care issues. Keep in mind this is still a compliance issue and one that should be add...
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Split/Shared Visits - What are they and how to bill
While The CMC Group is primarily focused on the physician side of reimbursement and compliance we have recently been spending a lot of our consulting time working on the facility side and one of the items continuing to surface are split/shared visits...
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Charging for Missed Appointments
There seems to be a lot of concern and confusion as to whether or not a practice can charge Medicare patients for missed appointments. The simple answer to the question is, Yes you can. However it becomes important to realize that this cannot be limi...
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Minimize the damage an audit can create
As many of you may know by now one of the main areas our firm specializes in is audit representation for providers who are going through an audit or have gone through an audit and are now in need of representation to minimize the damage an audit can ...
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