March 5, 2021
News & Insights

Q: What elements must be included in a provider’s documentation of individual psychotherapy to ensure accurate CPT coding for these services?

March 8, 2021
News & Insights

Q: Do we need to submit a formal request to CMS for any of the COVID-19-related waivers to apply? Do we need to keep records or documentation pertaining to which waivers we've used and the services they apply to?

March 3, 2021
News & Insights

CMS is reminding organizations of Medicare Secondary Payer (MSP) billing and appeal processes after the agency inappropriately denied some claims.

March 4, 2021
News & Insights

Q: What are the encryption requirements when using Google Drive™, Dropbox®, or other information-storing applications? How do we ensure HIPAA compliance when using them?

March 3, 2021
News & Insights

Q: As of May 1, UnitedHealthcare, the largest health insurance company in the United States, will be switching from using Milliman Care Guidelines (MCG) to InterQual. How will this affect organizations, and what can they do to smooth the transition?

March 2, 2021
News & Insights

Gore Medical Management LLC, a healthcare provider based out of Griffin, Georgia, reported a breach last month that impacted 79,100 individuals, according to the Office for Civil Rights (OCR) breach report.

March 1, 2021
News & Insights

Q: What are the recommended primary focus areas when auditing the chargemaster and charges?

March 1, 2021
News & Insights

A new report from the Office of Inspector General (OIG) shows that Medicare billing for high-level inpatient stays increased over a six-year period, sparking concerns by the government about upcoding.

February 26, 2021
News & Insights

Q: When two conditions are both present on admission, both meet the definition to be the principal diagnosis, and are “equally treated,” my understanding is that the condition does not have to be "equally treated" in the sense of duration/frequency. Is this correct?

February 24, 2021
News & Insights

Automating claim transaction saved the healthcare providers, including medical and dental providers, and payers $122 billion in 2019–2020 and moving to fully electronic transactions could yield an additional $16.3 billion in savings, according to the Council for Affordable Quality Healthcare Inc. 2020 Index.

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