Posted and filed under Coding.

Ambulance and EMS Transport Coding

The need for ambulatory services has seen an increase in recent years, and as a result ambulance transport claims have also risen. Payers generally cover ambulance services for patients whose medical condition is such that air transport is medically necessary. EMS Transport Coding is a unique coding set of non-physician provider services, where medical necessity…

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Posted and filed under Coding, ICD-10.

ICD-10 Codes That Will Haunt You

For a long time, ICD-10 was regarded as a nightmare for healthcare providers and their billing teams. The healthcare industry “woke up” and eventually embraced the reality of ICD-10, only to be faced with another monster; MACRA. This Halloween, we’re taking it back to more simple times and exploring the spookiest ICD-10 codes you’ll ever…

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Posted and filed under Coding, Fraud.

Chiropractic Billing Red Flags

All insurance payers are obligated to perform routine reviews of claims submitted by providers who operate under their plans. In recent years these claims examinations have gotten more rigorous, with antifraud initiatives being pushed by private health plans and those operating under the umbrella of CMS. The prevalence of insurance fraud has created a hypervigilant…

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Posted and filed under Coding, Compliance.

Understanding the Vaccines for Children Program

Please refer to our accompanying article Vaccine Administration Counseling for more information on vaccine coding and documentation. The Vaccines for Children (VFC) Program is a federally funded program that offers vaccines at no cost for eligible children through doctors enrolled in the program. The CDC provides information for Healthcare providers to become a VFC provider….

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

How Much Are Your Policies Costing You?

A medical record audit can reveal over-payments for up-coding, incorrect numbers of units billed, and the abuse of modifiers – just to list a few. Given the popularity of such indiscretions, what is being done after the money is recovered? Do you intend on data mining again in six months, hoping that the provider will…

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Posted and filed under Coding, ICD-10.

Zika Virus – More Than A Mosquito Sized Threat

The mosquito-borne disease known as Zika Virus has been dominating headlines across the world for several months, with doctors warning high risk populations of the symptoms and signs of the disease. The initial consensus was that while the severe symptoms are terrifying and problematic, death is a distant concern. This tune quickly changed last week,…

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Posted and filed under Coding, Events.

Advize Health Incident-To Audits Webinar Recap

On April 21, Advize Health held our monthly webinar on Incident-To Audits. Melissa Jewett, Advize Health’s QA Specialist and auditor guided attendees through the informative presentation, taking time in the end to hold an open Q&A session. Melissa is a highly qualified professional, holding both CPC and CPMA certifications from the AAPC. The presentation tackled…

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Posted and filed under Coding, FWA, Payers.

Vision vs. Medical Coverage Making You Bleary-Eyed?

Billing issues, to an extent, are expected in any physician or healthcare provider office. Most patients are in possession of both medical and vision benefits coverage, and this duality often causes confusion in ophthalmology offices. Certain procedures that are performed in an ophthalmology office should be billed as medical procedures, and do not apply to…

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

Advize Health Meaningful Use and Security Risk Analysis Webinar Recap

On March 10, Advize Health held our fifth monthly webinar on Meaningful Use and Security Risk Analysis. For this webinar, Advize Health’s auditor Melissa Jewett presented with Don Waechter from Compliance and Remediation Services, LLC. Both Melissa and Don are highly qualified to deliver such an informative webinar; as Melissa is a Certified Professional Coder…

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Posted and filed under Coding, Community.

The Importance of Professional Collaboration

The ecosystem of a professional environment is truly the sum of all its parts.  Effort from all members of the workforce community creates a feedback loop that is essential to a thriving business.  The mechanics of this infrastructure will then branch out, making contributions that feed surrounding ecosystems.  For Advize Health, our ecosystem revolves around…

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