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Don’t get caught up in duplicate claims denials; turn to modifiers, resubmit as needed

02/05/2018

Avoid seeing automatic denials on duplicate claims that you may unintentionally file by paying close attention to the nuances of repeat procedures and the modifiers you can report to get your claims successfully out the door.

Does your EHR contract cover a cloud collapse? Ask after Allscripts debacle

02/05/2018

by: Roy Edroso

The failure of Allscripts’ electronic health record (EHR) server, which left about 1,500 providers high and dry for days, serves as a warning that offloading your server-side operations isn’t a foolproof defense against hackers – and that you may find yourself without coverage for days lost by your vendor.

Beware of 3 ABN pitfalls plus answers to 6 key ABN compliance questions

02/05/2018

by: Julia Kyles

Make sure your practice isn’t falling behind on compliance with Medicare’s rules for the advance beneficiary notice of noncoverage (ABN). The ABN process is complicated and continues to trip up practices, warned Maxine Lewis, CMM, CPC, CCS-P, president of Cincinnati-based Medical Coding & Reimbursement.

CMS releases payments exceeding therapy cap despite end of exclusion

02/05/2018

by: Roy Edroso

Providers who submitted therapy claims that exceed the therapy caps and contain modifier KX (Requirements specified in the medical policy have been met) will start seeing their payments after a “rolling hold,” CMS announced Jan. 28.

Duplicate claim modifiers save some payments — but let down many others

02/05/2018

by: Roy Edroso

Don’t count on three modifiers to automatically redeem otherwise duplicate claims: The most recent data show the overall denial rate on codes claimed with the modifiers went into double digits, with some individual codes performing especially badly.

Proposed conscience protection rule would require compliance shift, careful hiring

02/01/2018

by: Roy Edroso

A proposed rule seeks to strengthen conscience protections for providers who don’t wish to perform, refer for or provide information on procedures that offend their religious or moral sensibilities. If finalized, it will require you to expand your compliance programs — and possibly rethink your personnel decisions.

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