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Taking Advantage: Sending a Message to Medicare Advantage

We’re supposed to play by the rules but not everybody does. That’s especially disappointing when that person works for the government. Recently, a former state insurance commissioner pleaded guilty to healthcare fraud. How ironic—the very person entrusted with safeguarding the consumer against insurance fraud goes on to engage in a $2.5 million scheme involving false […]

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From Overwhelming Billing to Thriving Practice: Coronis Health Empowers Your Gastroenterology Practice 

Running a successful gastroenterology practice involves a delicate balance. While you focus on delivering exceptional patient care, the intricate complexities of billing and coding can become a source of frustration. Lost revenue, administrative burdens, and the constant challenge of staying compliant with regulations can hinder your practice’s growth and impact your commitment to patient well-being.  […]

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Can a Smaller Practice Survive? The Anesthesia Question of the Day

In this era of mergers and aggregation, anesthesia practices nationwide are contemplating their futures, and many are struggling with the notion that only mega-practices survive. Is it possible to maintain a focused niche practice that only provides services to one facility or a narrowly defined market or are such practices dinosaurs doomed to fail or […]

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Documentation Guidelines for Medical Direction by an Anesthesiologist Based on HCFA Final Rule on TEFRA 11/2/98

All States, GR 00-2, March/April, Inside This Issue The Final Rule on the Tax Equity and Financial Responsibility Act (TEFRA) published by the Centers for Medicare & Medicaid Services (HCFA) on November 2, 1998, included seven requirements for medical direction of anesthesia cases. The additional information that follows each requirement listed below is the documentation […]

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Impact of Improved PFS Conversion Factors

Last week, we sent out a special alert, which included news that the U.S. Congress had essentially halved the Medicare Physician Fee Schedule (PFS) conversion factor reduction for 2024, meaning there should be more money coming your way in Medicare payments than previously expected for this year. For your Medicare EOBs for services performed on […]

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Rebuilding and Restoration: UHG Makes Strides in Wake of Cyberattack

One of things that keeps life interesting is the release of new information. Americans have access to multiple cable news outlets and innumerable headline sources on the web and in print. Sometimes the information is distressing and sometimes it can be heartening. Today’s alert may be seen by many as an example of the latter. […]

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Cracking the Code: Conquering the Challenges of Orthopedic Billing and Coding 

The intricate world of orthopedics, encompassing the complex conditions affecting our musculoskeletal system, presents a unique set of challenges behind the scenes. Ensuring proper billing and coding for these specialized services demands meticulous attention to detail and a deep understanding of the healthcare landscape. Let’s delve into the intricacies of orthopedic billing and coding, dissecting […]

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Getting Paid for Someone Else’s Work: The Hidden Hurdles of Incident-To Billing

It’s not an unknown phenomenon. Getting paid for something that was at least partially performed or created by someone else is a well-established practice. Thomas Edison was well known for taking the inventions of others, including his employees, and appropriating them as his own, receiving the acclaim and a hefty pay day (Nikola Tesla was […]

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Special Report: CMS Releases Cyberattack Relief Funds Special Report

In an attempt to address the serious impact of last month’s cyberattack against Optum’s Change Healthcare—which went on to create ripples in the stability of the nation’s overall healthcare system—the Centers for Medicare and Medicaid Services (CMS) issued this past Saturday an announcement that it was providing immediate help. The agency has been in constant […]

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