Check out this article about a half-dozen changes to the adjudication of Medicare claims-denial appeals that are designed to ease a backlog of cases. The new rules for Medicare claim-denial appeals feature several changes crafted to ease administrative burdens and speed reductions in a backlog nearing 1 million cases. The new rules went into effect…
Medicare Advantage: You have probably heard some industry buzz about the recent investigations (and settlements) into risk adjustment fraud with several of the major insurers. United Health Group along with others, are accused of manipulating diagnosis codes to make patients appear to be sicker to achieve higher reimbursement outcomes via the Medicare Advantage program. Medicare Advantage allows providers…
Check out this article about how more small medical practices could benefit from and qualify for exclusions from the Quality Payment Program! Small practices could add points to their total performance scores in the merit-based incentive payment system and may qualify for an exemption from EHR requirements. More small practices may qualify for exclusions from…
Sharing helpful career advancing tips and strategies to sharpen the skills prospective employers look for in a coder! Emotional Intelligence (EI) – Many of us are familiar with IQ tests, which measure our intellectual abilities and intelligence. Many of us also believe that having a high IQ makes you the best candidate for any job. However, employers are…
Check out this article regarding the announcement that Anthem has calmed controversy over Colorado’s health insurance by submitting its proposed plan for 2018 to the state. Health insurance giant Anthem announced late Monday that it has submitted proposed 2018 plans to the state, easing fears that it might back out of Colorado’s health insurance exchange…
RT Welter & Associates is excited to present our monthly Code Spotlight! Each month, RT Welter & Associates will spotlight a unique CPT or ICD-10 code to profile and discuss practice applications of the code, as well as pertinent guideline reminders. CPT Code 20680 — Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail,…
CMS proposed a final set of codes in April’s hospital IPPS rule, including over three hundred changes. Starting Oct. 1, it will be possible to select a specific ICD-10-CM code when a patient is in remission from abuse of each of a variety of substances, including alcohol, opioids, cannabis, and nicotine. Those nine new codes…
As part of the new coding format for our newsletter, RT Welter is excited to offer you a new surgery coding series in which we want to help you! The 2nd week of every month we will highlight a complicated surgical case. This week we are highlighting a general surgery case. We want to hear…
In an email cyber notice, the U.S. Department of Health and Human Services (HHS) is warning healthcare provider organizations that there are ongoing impacts to the U.S. healthcare sector from the WannaCry malware. The Wanna Cry or Wanna Decryptor ransomware virus swept the globe last month and virtually shut down several dozen regional health authorities…
Most long term relationships are built on mutual trust and respect. Valuable relationships are not built on mistrust, fear or intimidation. Same holds true for the relationship your practice has with payers and especially payer representatives.