Providing Complete Clinical Information to Radiologists

It is not uncommon for radiologists to receive inadequate patient information that potentially compromises their diagnostic decision-making abilities and accuracy. The recent evidence-based study has shown that communication of clinical information to the radiologist, including patient complaints and indications for the imaging request, is required for a quality radiology interpretation process and for making recommendations. […]

Documentation Guidelines for Telehealthcare

Documentation requirements for telehealthcare are identical to those of onsite medical care. Documentation plays a significant role in establishing medical necessity for billing; adhering to regulatory compliance; and supporting your claim in case of internal and external audits. Documentation rules may change as per insurance carrier’s contracts outlining medical necessity expectations and state regulations that […]

Keeping Patient Credit Card Details Safe

A recent survey report regarding healthcare payment patterns reveals that, out of total patient payments, 73 percent of payments took almost a months’ time. While 12 percent of patients’ outstanding took more than 3 months to get paid. The same survey report also suggested that about 35 percent of provider revenue comes from patient pay. […]

Understanding Medicare Recovery Audit Contractor (RAC) Audit

What is Recovery Audit Contractor (RAC) Audit? As a combined effort to fight fraud, waste, and abuse in the Medicare program, Recovery Audit Contractor (RAC) audit was in place from January 1, 2010. The goal of the recovery audit contractor program is to identify improper payments made on claims for services provided to Medicare beneficiaries. […]

Understanding PAR and non-PAR Providers with Medicare

PAR and non-PAR Providers with Medicare The Center for Medicare & Medicaid Services (CMS) is a federal agency within the Department of Health and Human Services which manages and oversees the Medicare program for beneficiaries. Physicians are required to comply with numerous laws and regulations related to various aspects of their practice within the Medicare […]

Documentation for Interventional Radiology

Documentation for Interventional Radiology Many interventional radiologists believe their only audience is the referring physician and fails to remember that there is a larger financial audience which includes medical coders, insurance carriers, auditors, and reviewers to name a few. Even though you know in detail the procedure you performed, unless it is clearly documented using […]

Appropriate Use of Modifier 25 in Cardiology

Defining Modifier 25 Modifier 25 is a significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service. It may be necessary to indicate that on the day a procedure or service identified by a CPT code was performed, […]

Understanding Synchronous & Asynchronous Telehealth

When researching your options for telehealth and telehealth solutions, you will likely hear about the two forms of telehealth: synchronous and asynchronous. Understanding how these forms of telehealth differ and what makes each a worthwhile form to consider is critical to achieving the goals of your telehealth program. In this blog, we will define these […]

CPT Codes for Digital E/M Service

In the 2020 CPT codes set, CMS six released new codes to report online digital evaluation services or e-visits. The codes describe patient-initiated digital communications provided by physicians or other qualified health professionals, codes are 99421, 99422, and 99423. Three others who describe similar interactions when they involve a nonphysician health professional are 98970, 98971, […]

Basics of Value-Based Care

The patient reimbursement model plays a crucial role in patient satisfaction, providers are always trying to improve the patient experience by reducing the cost of service. Most providers use a fee-for-service (FFS) model, which incentivizes physicians based on the number of services provided instead of the quality of care. However value-based care seeks to change […]

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