American Physician Financial Solutions

by AJ Riviezzo   Over the past years quite a number of practices have added phlebology to their existing operations. The increase in RAC audits have pointed out some documentation difficulties that these practices are experiencing including an inability to survive an audit without recoupment of monies. I would like to outline a few items to consider […]

by Cheryl Nash   An increasing trend in payer products are plans with narrow or limited networks. Touted as a move towards providing better care while reducing cost, these plans can be hard to spot by a practice unfamiliar with the nuances in reading the product names, network types, and abbreviations noted on the patient’s insurance […]

by Cheryl Nash   Confusing on the best of days, commercial payers are creating new guidelines surrounding the billing practices for Mid-Level providers. Initially categorized under Non-Physician Practitioner (NPP) and more recently referenced under Advanced Practice Provider (AP) these policies vary greatly in what the payer will allow in regards to who/what NPI is required as […]

by AJ Riviezzo Apparently, Medicare had decided to balance their budget on your labor. With the proposed cuts to reimbursement and the dramatic increase in Recovery Audit Contractor program (RAC), there seems to be a big push currently to retain and recoup as much money as possible. Over the past six months, the number of […]

by AJ Riviezzo There has been some ‘noise’ out in the phlebology community regarding the use of Varithena. I would like to present some information for your consideration. The Varithena codes, 36465 and 36466, are only to be used if you are using the Varithena product. The CPT code description clearly states that the code […]

by AJ Riviezzo There has been a good bit of debate on the AVLS Member’s Community board regarding when conservative therapy begins. Here is my ‘take’ based on what I have seen transpire during RAC audits. Many practices believe if you document the patient’s word regarding use of stockings that this will suffice. It will […]

by AJ Riviezzo First Coast Service Options (who services Florida and Puerto Rico Medicare Part B patients) and Novitas Solutions (who services Colorado, New Mexico, Oklahoma, Texas, Arkansas, Louisiana, Mississippi, Delaware, DC, Maryland, New Jersey, and Pennsylvania) have proposed new Local Coverage Determinations (LCD’s) likely effective 1/1/2021. While not all of our readers will be […]

by AJ Riviezzo One of the more non-compliant elements that small practices have is the lack of a completed Business Associate Agreement (BAA). This is a relatively easy element to accomplish that can help ensure HIPAA compliance of your non-employee relationships. A ‘business associate’ is someone that does work for you without being a direct […]

by AJ Riviezzo There has been an upsurge in the number of phlebology practices receiving requests for medical records from Recovery Audit Contractors (RAC). These contractors are empowered by the Medicare Fee for Service Recovery Audit Program. The keys to this are in the very definitions I believe. First, the good folks doing the audit […]

by AJ Riviezzo With reimbursement for procedures dropping, it is becoming essential for a practice to be mindful of every expense including hidden ones. Credit card processing fees are one such example. With deductibles, copayments and coinsurance always increasing; an ever-growing percentage of your total reimbursement is coming from the patient. Most of whom prefer […]