Category: Blog

medical necessity errors

Top Error Rates Offer Clues to Denials

The Comprehensive Error Rate Testing (CERT) program grew out of the Department of Health and Human Services Office of Inspector General improper payment rate estimates from 1996 through 2002. Due to sample size restrictions, the Centers for Medicare & Medicaid Services (CMS) assumed responsibility because they had access to more granulated data in 2003. The […]
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Telehealth Usage Statistics

Telehealth Usage Rises with Increase of Covid-19 Cases

As the nation began experiencing an uptick in COVID-19 cases this fall, a similar upswing occurred in the use of telehealth, according to the latest report from FAIR Health, an independent, nonprofit organization, which tracks commercial insurance claims as part of a healthcare cost transparency initiative. Compared to one year ago, October usage of telehealth increased […]
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Guidelines for Office Outpatient EM Services

6 Questions Ensure E/M Compliance

Examine the utilization of Master Data Management (MDM) for coding office visits in 2021 from an auditor’s standpoint. When educating healthcare practitioners on the 2021 documentation guidelines for office/outpatient evaluation and management (E/M) services (codes 99202–99215), it is advisable to adopt an auditor’s perspective. A comprehensive auditor’s toolkit comprises four essential components: diagnoses, data analysis, […]
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CPT 2021 Lab Code Updates

CPT 2021 Update: New Lab, Category III Codes

  CPT® 2021 code updates for quarters 2 and 3 have been released by the American Medical Association (AMA). The new, revised, and deleted codes will be updated in Codify by AAPC as the changes go into effect. Make sure your practice updates other coding resources such as the CPT® 2021 code book and electronic […]
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AI in Remote Proctoring

How AI and AR are Changing Medical Proctoring During COVID-19

  Medical device specialists often monitor the work of surgeons to provide case support during procedures in the operating room. However, during the COVID-19 pandemic, medical proctoring has gone remote. “COVID has dramatically accelerated the need to have a remote tool, when you either don’t have access to the hospital, or when there are travel […]
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Predictive Healthcare Forecasting

Predictive Healthcare Forecasting Key to Provider Survival in 2021

Healthcare forecasting that can adapt quickly to changes could be as critical to a provider organization’s survival in 2021 as wearing a mask to stop the spread of COVID-19, experts at PwC’s Health Research Institute are saying. Nearly three-quarters of healthcare executives (74 percent) recently surveyed by the Health Research Institute said their organizations would […]
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2021 Evaluation & Management Code Changes

A Glance at 2021 Evaluation and Management Changes

The evaluation and management (E/M) changes for calendar year 2021 are the result of a collaborative effort between the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS). CMS first addressed the changes in the 2020 Medicare Physician Fee Schedule Final Rule, in which CMS indicated that it planned on adopting […]
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Artificial Intelligence in Healthcare Sector

How AI is Lending Hand in Healthcare

Healthcare seems to be important in all areas where Artificial Intelligence (AI) is promising. This likelihood is because healthcare services are overwhelmed by workforce shortages, inadequate medication, increased patient burdens, and inaccurate diagnosis, all of which may help a degree by modern technologies. Imminent prospects for AI in healthcare comprise health assistance and medication management, […]
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