Lack of a teaching physician statement in a patient’s record can lead to denied services. Minimum Requirements A teaching physician’s statement must explain who rendered the service as well as if he/she was physically present during the furnished service. The record must always explain the teaching physician’s participation [...]
Medical necessity of inpatient care is determined by a combination of factors including the physician’s assessment of the patient’s history and physical, commonly referred to as the H&P, as well as the review of specific risk factors that are characteristic to the patient’s condition at the time of admission. [...]
The Merit-Based Incentive Payment System, MIPS, seems to be the new buzz word in every doctor’s office. Everyone is asking questions about MIPS: What is MIPS? How will it affect my practice? What do I need to do to avoid a potentially negative impact? If any of these [...]
Specific requirements must be met for treatment to be considered critical. There are two critical care care CPT codes, 99291 and 99292. 99291: 30-74 minutes of critical care provided to a patient on a single date. Reported per date of service. 99292: additional set(s) of 30-minute increments of [...]
Autism, a neurodevelopmental disorder, is a complex disability affecting 1 in 68 children. It is now common for those diagnosed to follow a treatment plan. Some insurance policies require a treatment plan outlining the frequency and expected outcomes/goals for the services provided. State laws often require certain doctors, such [...]
A capitation payment is a fee or payment of a uniform amount per each person. In regards to nephrology groups, Medicare’s monthly capitation payment is paid to physicians and practitioners for most of the outpatient dialysis-related services they provide to end-stage renal disease patients. The payment amount will vary [...]
Transitional Care Management (TCM) is the service provided to a patient whose transition from an inpatient medical facility back to their home requires moderate or high-level complex medical decision making. Qualifying facilities for the patient’s inpatient medical stay include inpatient hospital, partial hospital, observation status in a hospital, [...]
There is strategy to making sure patient collections are as sufficient as possible. Here are some of the key components to increase patient billing while making sure your process is thorough and without neglect. Obtaining Patient Information The initial step to ensuring receipt of accurate patient collections [...]
Are you having claim denials due to insufficient medical records? Does your office have concerns about whether your record-keeping system is thorough? The point of a medical record is to enable safe, accurate, and thorough care for your patient. For insurance reimbursement, medical documentation needs to show adequate [...]
Current technology combined with the need to develop greater convenience and a broader spectrum in the healthcare industry has allowed for the incorporation of telemedicine into the medical field. Within the United States, hospital physicians began experimenting with telemedicine over 50 years ago. Currently, due to the transformation of [...]
