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Providers should keep in mind that such policies aren’t binding – but can offer valuable direction. Imagine your Medicare Administrative Contractor (MAC) had a policy detailing their coverage of records documented by a scribe.  Say that policy had been revoked. You have located a policy by another MAC, CGS. Would it be…
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Providers are encouraged to file protective appeals. “In section XI of the preamble of the proposed rule, we discussed the growing number of Provider Reimbursement Review Board (PRRB) appeals made by providers and the action initiatives that are being implemented with the goal to decrease the number of appeals submitted;…
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Understanding how each physician’s specialty is properly registered. As you might know, one of my primary projects is predicting the likelihood that a particular provider may be audited – and if so, which procedures, codes, and/or modifiers are most at risk. To a large degree, this type of target acquisition…