ROI FROM HUMANA PRIOR AUTHORIZATION PLATFORM DRIVES NATIONWIDE EXPANSION IN LESS THAN ONE YEAR

The ROI from Humana prior authorization platform is driving a nationwide expansion in less than one year. This expansion will improve healthcare processes and costs. Continue reading below to learn more! “This is a re-imagined PA process, one where expedited approval becomes the standard,” says one Humana executive. KEY TAKEAWAYS Humana’s prior authorization platform authorizes…

Behavioral Health – Interactive Complexity Guidelines

By: Sheila Haynes, Manager Coding & Compliance Defining Interactive Complexity +90785: Interactive Complexity (+90785) is an add-on code utilized for office visits with a psychologist or other mental health professional that are complicated by language, behavior, emotions, mandated reporting requirements or trauma. +90785 is utilized in addition to one of the following primary service codes…

OIG Spotlight – Modifier 25

Modifier 25 is an important Evaluation and Management service medical professionals need to understand. It is used for same-day procedures when services beyond usual pre and post-operation are necessary. Continue reading below for a breakdown and examples of modifier 25! By: Sheila Haynes, CPC Coding and Compliance Manager Pay close attention to billing E/M (office…