Contracting VS. Credentialing
While often used as synonyms, at the HMO/PPO they are two very different processes conducted by two very different departments. Credentialing is a review of the physician or physician extender. It is a meeting of the credentialing team, typically physicians… Read More
Hardship Exemptions
Medicare delayed publication of the meaningful use guidelines for stage 2 and did not meet their self-imposed 90 day notification timeframe. This has created a window of opportunity for the practice to file a 2015 hardship exemption to avoid… Read More
Year End Update on New Technologies
During the past year we have commented on some of the newer technologies. As I still receive a number of questions about them, I thought an end of year re-cap might be in order as we all begin to contemplate… Read More
2016 OIG Work Plan
The Office of the Inspector General’s work plan for 2016 has been released, and after reviewing the plan for next year, we are happy to report that there is not much of concern to the phlebology practice. Of note is… Read More
Phlebology Colorado
Skiing, Sharing, Learning On the last weekend of January, the 28th through the 30th, Phlebology Colorado is hosting their 7th annual meeting in Telluride, Colorado. The link to this event is: http://www.conferencematters.co.nz/colorado/index.php
Working the Accounts Receivables
Diligence and documentation are the keys in receiving payment for a claim that somehow moves sideways. We recently had an ablation from October, 2014 that went sideways with Harvard Pilgrim. The claim was submitted in a timely fashion. This is… Read More
Anthem Ultrasound Changes
Anthem’s Medicare Advantage department recently published an Outreach and Education Bulletin regarding Outpatient Diagnostic Imaging. A copy of the full bulletin can be found using the link below. Beginning November 1, 2015 Anthem Medicare Advantage will begin collecting information about… Read More
Medicare LCD Review
One of the questions I receive from different physicians throughout the year is: “Will phlebology still be in existence and paid for in the years to come?” My initial answer is “I sure hope so” since we are as invested… Read More
93970 vs. 93971 – Usage and Charting
More payers are applying increased scrutiny to diagnostic services, with diagnostic imaging at the forefront of this trend. Diagnostics have gotten a bad rap over the last several years as the target in several whistleblower cases and audit recoveries requiring… Read More
Witch Hunt!
While Halloween may have just passed, the Witch Hunt apparently is just beginning. Two different physicians in two different states who have Noridian as their Medicare Administrator (MAC) have received letters noting a PRE-Payment audit of some of their claims…. Read More