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Despite slow progress, hopes for steady growth endure. Is telemedicine about to get a big financial boost? Maybe, but regardless, momentum seems to be with it these days regardless. For many years, telemedicine advocates have worked to put it in the mainstream of healthcare services – no small task, considering…
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Should hospitals combine two admissions into one? In the absence of CMS guidance, hospitals are urged to do the right thing. Today I have a confession to make. For the last five years, I have been lying. Now, don’t get me wrong; I have not been doing it on purpose.…
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CMS has accused Bryan Merrick, MD of wrongful Medicare billings on 10 patients over a span of 20 months. Bryan Merrick, MD, a physician at the Tennessee-based McKenzie Medical Center who has been practicing medicine for more than three decades, will be a central topic of conversation during the next…
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The presence of Medicare Advantage plans in the healthcare marketplace continues to grow. Unless you have been living under a rock, you are aware that healthcare has been a topic firmly positioned at front and center in Washington, D.C. for the past nine months. This past week has been highlighted…
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Healthcare professionals are urged to assess the palliative care program at their respective hospitals.  Today I want to talk about death, but not about how to bill it or code it. Instead of that, today I want to talk about the care we provide patients as they approach death. And…
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More than three dozen advocacy groups appear to sway position of one of the nation’s leading carriers. In the June 2017 UnitedHealthcare (UHC) Bulletin, it was indicated that the carrier would no longer cover consultation services within the evaluation and management (E&M) service codes, effective Oct. 1, 2017. UHC noted…
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In the aftermath of the devastation caused by both Hurricanes Harvey and Irma, the Centers for Medicare & Medicaid Services (CMS) has issued blanket waivers of some the regulatory requirements for hospitals and post-acute care settings to support access to services and allow healthcare facilities to provide timely care to…
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Late last week a case management colleague distributed an insurance company memo that had been sent to her hospital to a Recovery Audit Contractor- (RAC)-related user group. This memo required a double-take to ensure that it was not five months old, because it should have been distributed on April Fools’…
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When hospital executives are asked about their specialty programs, both in terms of reputation and profitability, orthopedics and cardiology are often on the top of the list. But that may soon be changing. A great deal of attention has been paid to the proposal by the Centers for Medicare &…
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How many of us remember the 90010? That was an evaluation and management (E&M) code in 1991, prior to the revision that still haunts us today. Back then, in the good old days, E&M codes were qualitative in nature, meaning that their use was based on physicians’ interpretation of the…