ANTHEM POLICY CHANGES
by AJ Riviezzo Anthem Blue Cross and Blue Shield just came out with a new Clinical UM Guideline effective April 10, 2024. While you may not be in a state with Anthem, the odds are good that some Anthem patients will… Read More
WHY DID THEY CLOSE?
by AJ Riviezzo Over the past five years I have worked with some practices that have closed their doors. It is a painful decision for the practice and the physician owner in particular. I am frequently asked why a practice may have… Read More
MEDTRONIC CHARTING WEBINAR
Tuesday, October 24, 6 pm CT Medtronic: Superficial Venous Charting & Documentation Best Practices Medtronic Reimbursement: Superficial Venous Charting and Documentation Best Practices with AJ Riviezzo Click here to register: Please join the Medtronic Health Economics, Policy, and Reimbursement team… Read More
UPDATE TO AETNA PROPOSED POLICY
by AJ Riviezzo There has been a lot of noise and fury on the policy that was proposed and purported to be Aetna’s new Varicose Vein directives effective September 1st. There are now a few caveats to the ‘policy’ along with… Read More
AETNA PROPOSED POLICY
by AJ Riviezzo Aetna is proposing a rather significant change to their Varicose Vein policy with an effective date of September 1 of this year. The three key changes are: Other criteria listed includes: Adjunct therapies such as Varithena, sclerotherapy or… Read More
A FEW MORE BASICS
by AJ Riviezzo There are other elements outside of charting that the practice should review. Authorizations – It is, obviously, important to obtain an authorization when required. Most everyone does that fairly well. There are two less noticeable issues that seem to… Read More
BACK TO BASICS
by AJ Riviezzo During the past quarter, we have been privileged to review a number of charts. There are some common basic themes we continue to see when performing these audits. You may want to take a few minutes and compare the… Read More
Phlebology Specific H&P’s
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… Read More
Limited Network Plans
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… Read More
Mid-Level Billing
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… Read More