After years of Litigation, E/M Denials Persist
Notwithstanding years of litigation and multi-million dollar settlements, many healthcare providers continue to experience inappropriate evaluation and management service (“E/M”) denials. Earlier...
View ArticleMedicare to Stop Paying for Certain “Never Events”
Beginning tomorrow, Medicare will no longer provide reimbursement for certain newly added “never event.” In particular, Medicare will refuse to provide reimbursement for the following conditions:...
View ArticleAnthem BCBS of Indiana Climbs On Board the Pay-For-Performance Bandwagon
As regular readers of this blog may recall, last year, Medicare implemented its Physician Quality Reporting Initiative,which is also known as PQRI. Doctors who satisfied the quality of care and...
View ArticleJury Awards Deaf Patient $400,000 for Doctor’s failure to Provide Interpreter
In a remarkable development, a New Jersey jury has just awarded a deaf patient $400,000 for her doctor’s failure to provide an American Sign Language (“ASL”) interpreter. According to the complaint...
View ArticleE-Prescribing Developments and Considerations – Part I
With increasing frequency, healthcare providers are giving serious consideration to the adoption and implementation of an E-Prescribing system. Some of the most often cited reasons include the...
View ArticleE-Prescribing Developments and Considerations – Part II
One of the primary reasons for the current swell in interest in E-Prescribing is Medicare’s 2009 bonus. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (“MIPPA”)...
View ArticleE-Prescribing Developments and Considerations – Part III
There are three primary requirements for earning a Medicare E-Prescribing bonus. Today, we will address the first of the three requirements, which is the consistent usage of a “qualified” E-Prescribing...
View ArticleE-Prescribing Developments and Considerations – Part IV
As previously discussed, there are three main requirements for earning a Medicare E-Prescribing bonus. During the prior blog we considered the first requirement, i.e., the use of a “qualified”...
View ArticleE-Prescribing Developments and Considerations – Part V
Many providers have asked for information regarding the application process for participating in E-Prescribing. In fact, there is not a formal, onetime application. However, a provider (or practice, as...
View ArticleReal Time Claim Adjudication – The Next Generation of Claims Submission
As a result of the rising cost of healthcare, today’s patient pays more for their healthcare which puts an increased burden on physicians to seek collections from patients. This component of a...
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