Support Tools Patients may want services or products you offer that are not covered by their insurance. Some of these may be deemed experimental or unproven, according to various 3rd party payors or Examining Boards. The service or product may be the very reason the patient booked an appointment in the first place. To prevent…
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Obtaining Patient Acknowledgment Some carriers (with whom the doctor may or may not participate) may not allow a particular service or product the patient needs, or their fee schedule assigned to the service or product may be far below the doctor’s costs. Depending on the doctor’s contract with the carrier, the patient may be able…
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OIG Oversight & Enforcement When it comes to oversight of coding and documentation compliance on the Federal level, the top of the totem pole is the Office of Inspector General (OIG) for the Department of Health & Human Services (HHS) . The mission of the OIG is to protect the integrity of the HHS programs…
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Coding Unique Services Doctors want to help their patients and will use various tools of the trade to help get them better. We often see a steady stream of the perpetual “latest and greatest” item intensely marketed to healthcare professionals. The fine line between the business and clinical sides of the practice are sometimes at…
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Healthcare Documentation Has Many Facets and Requirements To meet the standards expected by the many different audiences that review your patient records, you need to be familiar with the standards set by the healthcare community at large. That standard is defined by The National Committee for Quality Assurance (NCQA). NCQA is an organization dedicated to…
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The doctor’s responsibility is to maintain ethical standards, in practice and in policy, in all facets of their health care practice. Practitioners often get themselves into hot water when coding and documentation are incongruent. There is a right way to document and a right way to code. Yearly changes to coding may apply to the…
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