Posted and filed under Compliance, Medical Record Auditing.

Sign, Seal, Deliver: Provider Signature Requirements

To a physician, providing authentication may appear as yet another inconvenience or hindrance to productivity in the midst of the already chaotic audit process – but it’s the difference between being reimbursed and having your claims denied. For the purpose of a medical record audit, Medicare requires that any services provided be authenticated within the…

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Posted and filed under Coding, Medical Record Auditing, Payers.

Think Twice Before Appending Modifiers

Coding Modifiers In the English language, a modifier is used to describe the who, what, how, why, and/or where of a situation. Coding modifiers perform the same role for medical coders and billers. These types of modifiers further describe procedure codes without altering its original definition. Modifiers can be found in both the CPT and…

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Posted and filed under Compliance, Medical Record Auditing.

Surviving the Medical Record Retrieval Process

Tackling a project as intricate as Medical Record Retrievals may seem daunting – and it is, but you can still make it through unscathed. Perhaps your firm was enlisted by an attorney, health plan, or medical auditing organization to retrieve medical records directly from a provider’s office. What tools do you need? How do you…

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Posted and filed under Cybersecurity, Healthcare, Technology.

Cover Your (Data) Bases: Recap

Late last month, Advize Health’s Managing Director, Jeanmarie Loria teamed up with Regine Bonneau of RB Advisory LLC to deliver a presentation on IT Inventory and standard security measures. This webinar was free to all attendees and included a discussion on the importance of IT Inventory, and the technologies available to help organizations maintain their…

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Posted and filed under Business, Healthcare, Payers.

Value-Based Purchasing Still Perplexing Providers

Providers are still struggling to align with payers in the transition to value-based purchasing. Value-based purchasing is used to measure, report, and reward excellence in health care delivery. To properly incentivize high-quality care, value-based purchasing requires the cooperation of employer purchasers, public sector purchasers, health plans, and providers who are all tasked with assessing care…

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Posted and filed under Community, Cybersecurity.

When You Give, You Get

“Diversity and inclusion are central to the vision, strategy, and success of Advize Health. We strive to attract and retain talented and diverse people and suppliers, while creating an inclusive, productive, and respectful environment where all employees can contribute to their fullest potential.” The declaration above is the Advize Health Mission Statement, one that remains…

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Posted and filed under Uncategorized.

Florida Healthcare Fraud Heats Up

Florida is a hot state, but it’s also been named a Hot State for healthcare fraud by several agencies. Two of the most common questions that we’re asked here at Advize Health are: 1) What do you do, and 2) Why are you located in Florida? Our responses to both questions are heavily rooted in…

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Posted and filed under Coding, ICD-10.

ICD-11 Scheduled to be Finalized by 2018

Just when you thought it was safe, the World Health Organization has announced that the International Classification of Diseases is undergoing the 11th round of revisions. ICD-11 is scheduled to be finalized for presentation to the World Health Assembly by 2018, and is intended to be even more comprehensive than ICD-10. It’s understood than the…

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Posted and filed under Coding, YouBeTheCoder.

You Be The Coder: Evaluation and Management (E/M)

Assess your knowledge of Evaluation and Management while taking our free E/M Calculator for a test drive! Review the below patient notes and plug the appropriate information into our audit tool. History of Present Illness (HPI) Patient is complaining of chest pain which he has been experiencing on and off for two days now. He…

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Posted and filed under Coding, Compliance, FWA, Healthcare.

Pre-Litigation Considerations

Law firms have been known to enlist the help of a third-party when dealing with healthcare fraud cases. This is because in addition to investigating the allegations against one party, there is a myriad of additional pre-litigation considerations. In multi-faceted cases in which health plan overpayments are being pursued within the judicial system an audit…

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