Working directly with providers in assisting them with Medicare compliance requirements, we have found areas of great concern in the billing process.
Seamless and simple Medicare reimbursement starts with understanding the options and plans you’re working with.
Take a moment to learn about this very important federal requirement.
Don't fall into the trap of thinking you can require your Medicare patients to pay cash and avoid enrollment.
When properly enrolled in Medicare, providers choose their status as either Participating or Non-Participating.
Take 10 minutes to learn the difference and how to establish a compliant ABN process in your clinic.
Documentation & Coding
Proper documentation, billing, coding, and office procedures are needed to ensure that massage therapy is being used in a compliant manner.
This Rapid Solution provides a brief overview of the requirements for billing code 97140 for manual therapy.
This Rapid Solution will examine the compliant way to code and document for full spine adjusting.
When treatment is no longer considered medically necessary but still needs to be reported to payers, determine if it is most appropriate to use a maintenance diagnosis code, procedure code, or append a modifier.
Box 14 is one of the most important compliance-related concepts that every DC and CA must understand.
The best way to advocate for the benefits your patients are entitled to is to understand the definitions of medical necessity and clinical appropriateness and to learn how to document these services correctly.
Is your reimbursement process a victim of code edit changes from a payer? This quick tutorial will help a provider to be reimbursed for what they do.
Be proactive! Avoid denied claims by learning more about ASO plans and how your clinic can build processes around them.
Do you have self-pay patients in your clinic? Are you offering a Good Faith Estimate? If you answered No, to the last question, check out the overview and helpful resources in this quick tutorial.
Heads Up! All out-of-network providers who are performing procedures at an in-network facility have new billing protection laws to abide by. Find out what is required if you fall into this category.
This Rapid Solution explains what the OIG believes is a fair discount and the correct way to apply it to patient balances.
This Rapid Solution outlines the considerations necessary to best understand your costs of doing business.
Although portions apply to out of network providers, there are select portions that apply to in-network providers and cash-based clinics.
Gone are the days of staying out of network and not being required to have some type of communication or relationship with payers.
This lesson will bring a basic understanding of what it means to have an effective OIG Compliance program and why it is so important to take the time to install one.
Many contacts could be considered a Business Associate by HIPAA. Find out what this might mean for your clinic.
Every office should select a Compliance Officer - a person who will be the go-to person who will stay up to date on current OIG regulations and make sure they are being enforced.
It is important that you and your staff truly understand what Protected Health Information (PHI) is so that you can implement safeguards and protections and avoid a HIPAA violation.
In order to be compliant, you should know the ins and outs of what is referred to as Fee-for-Time Compensation (aka Locum Tenens). This Rapid Solution covers the basics and provides important coding information.
They say you only get one chance to make a first impression. This Rapid Solution outlines the high points of this important call and demonstrates use of the NP Phone Call Form.
This Rapid Solution outlines the most important steps of task identification, layout of a schedule, and the inner workings of the day-to-day responsibilities of chiropractic team members.
This Rapid Solution provides a quick overview of some of the more common profit centers used in many practices. Review to see how you might benefit from some of these options.
This Rapid Solution outlines the high level aspects of the three most important types of meetings we recommend: The Overall Team Meeting, Departmental Stand-Up Meetings, and the Daily or Pre-Shift Huddle.
This Rapid Solution provides an overview of important steps to consider for compliant delegation of services to team members.