Billing Compliance

When do you use modifier 25 or 57? Coding expert John Verhovshek explains the difference when coding an E&M service.

Your team of physicians, administrators and lawyers can help you get what you rightfully owe using data-driven tools.

Coding expert Bill Dacey has some of the most recent updates to the coding manual. What do you have to know for 2018?

Are you celebrating and thanking your staff on a daily basis? If not, you could be creating a negative working environment.

The coding rulebook is always changing. Here are strategies from our two coding experts to help you stay compliant.

Inaccurate billing and coding can have a direct and negative impact on a practice's bottom line. What are some common coding queries?

The Department of Justice filed its second lawsuit this month against UnitedHealth, alleging inflated risk adjustment payments.

Everything you want to know about coding a transitional care management encounter, including what services are included.

A recent survey explores how patients and practices don't see eye to eye when it comes to billing and payment.

Today's practice must be in tune with the reality of healthcare consumer demands, including using electronic billing services.

Do you have fail-safe measures in place that alert you when a payer is withholding your payments? If not, it's time to make a plan.

This month's coding column: An elderly patient's grown daughter comes in for an office visit without the patient, is there a code for that?

Physicians often look at their relationship with payers through an us vs. them mindset. That's the wrong tract to take says one doc.

The current state of our relationship is an illogical, Kafkaesque nightmare with a deadbeat. Yes, we're talking about you, payers.

Revised codes and coding guidelines for 2017 completely change reporting for moderate sedation services. Here's what you have to know.

The 2016 Physicians Practice Fee Schedule Survey reveals how much more employed docs get paid than independent physicians for certain CPT codes.

While there is a lot of uncertainty over what will happen in healthcare this year, one expert predicts that value-based care isn't going anywhere.

This month's coding column is on the biggest change to the 2017 CPT manual and billing related to depression and alcohol misuse screening.

More practices are falling victim to ransomware attacks, where hackers can lock out users from their EHR systems. Here is some guidance around this issue.

Some physicians will have a lot more to worry about this year than having to lose 10 pounds or improving their healthy eating habits.

How high-deductibles and copays are straining, but also strengthening, the trust between doctors and patients.

Change is coming. A repeal of the ACA, MACRA, and other vital issues will have to stay on a practice's radar in 2017.

Sometimes CMS can unjustly revoke a provider's billing privileges. Here are a few examples.

More than 20 healthcare professionals from a hospital in Texas are being charged with a kickback conspiracy involving over $500 million in insurance claims.

Some patients are just not going to adhere to a physician's guidelines; is it fair to get penalized by CMS for that?

Calculating your practice's percent collections a different way can tell a very compelling story of the economic health of your business.

In order for there to be a "Cancer Moonshot," healthcare needs to see advancements in the operational side of the industry, too.

What can practices learn from a recent ruling by the Supreme Court on the False Claims Act? An expert weighs in.

In our recurring blog “Inbox,” we share comments from physicians and others on the results of Election Day and how it affects the future of healthcare.

This month's coding column looks at whether or not you can count addressing routine chronic conditions without a change in plan of care as E&M.