Three revenue cycle tips are provided to reduce denied claims. Claim denials represent millions of dollars in lost and delayed net reimbursement annually. According to the American Medical Association (AMA), cost estimates of inefficient healthcare claims processing, payment, and reconciliation top out at $210 billion per year. Denials are so…
A look at the proposed Medicare Physician Fee Schedule. As you may be aware, the proposed Medicare Physician Fee Schedule (MPFS) rule for 2020 was officially published on Aug. 14, 2019.  There are many components to the rule, including a proposed change in the PFS conversion factor to $36.09, the…
Audits are being conducted by payers on being cost-effective with “wastage” of medication. When it comes to the JW modifier for discarded medication, there are things of which you might not be aware, especially, the administration of expensive pharmaceuticals such as chemotherapy. The verbiage that everyone is familiar with is…
The five “Ws” about the flu. It is that time of year again – flu season, which occurs in the fall and winter in the United States, stretching from early October until May. For me, it was a new experience this year, as I got my flu shot! I had…
A lesson in coding and policy.Medical marijuana, or cannabis, as it is commonly referred to in the healthcare field, is allowing chronically ill patients to relieve painful, often debilitating symptoms legally instead of taking pills many claim do little to ease severe pain. The widespread acceptance of marijuana as a useful…
Much attention and dedicated work have been devoted toward clinical documentation improvement and accurate, specific coding. Clearly, those are of great importance. However, I want to address the physician Part B insurance denials that have nothing to do with how good the clinical documentation is and how accurate the coding…