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2017 Guide To The Proposed and Final Rule Update for OPPS & PDBs

Posted by Lamon Willis, Nov 15, 2016 2:03:08 PM

For calendar year 2017, the Centers for Medicare & Medicaid Services (CMS) have finalized updated payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System.

Quick Guide To Medicaid and Medicare Managed Care Plans

Posted by Lamon Willis, Nov 8, 2016 10:01:00 AM

In Medicare and Medicaid services, managed care plans fall under Part C, a Medicare Advantage plan alternative to Parts A and B. Medicare Advantage plans often include integrated self-administered drug coverage similar to the standalone Part D prescription drug benefit plan.

The Best Online Resources for Medical Auditors

Posted by Lamon Willis, Oct 12, 2016 3:15:59 PM

Whether you need help making informed decisions for your organization regarding the RAC audits, or need a refresher on ethical e/m coding, this list of super useful audit resources has it all.

Essential Steps For Mastering Critical Care

Posted by Lamon Willis, Oct 11, 2016 12:59:42 PM

“CPT currently defines a critical illness or injury as an illness or injury that acutely impairs one or more vital organ systems such that there is a high probability of imminent or life threatening deterioration in the patient's condition.” -ACEP.Org.

Important Auditing Topics in 2016

Posted by Lamon Willis, Sep 15, 2016 12:22:01 PM

Annually, the Centers for Medicare and Medicaid Services (CMS) publishes its Fee-For-Service (FFS) Improper Payment Report, a result of the accumulated totals of the Comprehensive Error Rate Testing (CERT) audits.

11 Things to Consider Before Buying Auditing Software

Posted by Lamon Willis, Sep 13, 2016 12:47:50 PM

The long days of reviewing stacks of paperwork on your desk are finally over. But, spreadsheet tools like Microsoft Excel are terrible for healthcare.

Ask an Auditor Series: Auditing When There Are Conflicts of Interest

Posted by Lamon Willis, Sep 6, 2016 12:50:03 PM

We received a lot of great questions during our Conflicts of Interest Webinar.

3 Solutions to the Most Common Auditor Mistakes

Posted by Lamon Willis, Aug 23, 2016 3:35:01 PM

Auditing is hard work and requires a special kind of personality and superhuman attention to detail.