Billing & Collections

After a 15-month fight with Long COVID, author Lucien W. Roberts, III, MHA, FACMPE, retired in February 2022 on the advice of his primary care doctor and his wife…perhaps not in that order.In retirement, he spends a few hours a week at a freestanding infusion center he co-owns, writes the occasional article, and tries not to drive his wife too crazy.He may be reached at 

Articles

2021 has brought about the most extensive changes to CMS’s Evaluation and Management (E&M) guidelines since 1997.

E&M Coding in 2021: Four Questions, Four Answers

Extensive revisions aim to prioritize patient care information, resource-based reimbursement, and lessening the need for audits.

2021 E&M Changes: Avoiding pitfalls with the right technology-enabled strategy

 Technology Solutions and Founder of TRUSTEDi10

Why practices should not fear new coding requirements

2021 E/M guideline and leveling changes

CMS rules to simplify E/M coding and reemphasize patient narrative.

New 2020 HIT regulations: is the patient's story heard?

Practices are using E&M codes to bill for non-physician educational visits, but is this ok?

Non-physician provider use of E&M codes

Payers don’t dole out equal pay for equal work, so it benefits your physician practice to understand who pays what (so you can negotiate more).

Managing your payer mix to improve your bottom line

Coding expert Bill Dacey clears up some confusion about split billing and combination visits.

Coding for preventive care and chronic care management

In order to justify the Level 4 E/M visit, make sure you have recorded all necessary information-and clearly label it for the payer auditor to easily find.

Required documentation for 99214 coding

How to code varies on the circumstances. Many coding scenarios are determined by context-not absolutes.

Medicare on medical necessity and more on time-based coding

 advises clients on compliance, transactions, government administrative actions, and litigation involving healthcare, cybersecurity, corporate and securities law, as well as False Claims Act and Dodd-Frank whistleblower cases. She also teaches bioethics at Baylor College of Medicine in Houston. Rachel can be reached through her website, 

Proper billing and coding under CMS’s final rule is important not only for reimbursement but also to avoid potential lawsuits.