Healthicity Blog

Back to school season means a lot of things – summer is winding down, kids and teachers are heading back to the classroom, but for Carl, it means one thing: new pens and notebooks.

Modifier 59 is here, there, and everywhere!

It’s one of the most frequently used and misused modifiers in medical coding and billing, and it indicates that a procedure or service was distinct or independent from other services performed on the same day by the same provider.

A fundamental tenet of healthcare billing compliance is that services must be medically necessary.

“Think like a lawyer, talk like a human, and start with your audience."

Depending on who you ask, between 10% and 30% of claims are denied, lost, or ignored annually. That’s quite a chunk of change.

In June 2023, the U.S. Department of Health and Human Services Office of Inspector General (OIG) added many more items to their work plan. Let’s take a look at some that may be particularly important for compliance professionals in the health care industry.

A week without Wi-Fi means Ada can achieve the unachievable – a week without emails! A week without conference calls! A week without....audits!

Accurate billing and coding play a critical role in the complex realm of healthcare financing. However, concerns about upcoding have emerged as a persistent issue, potentially leading to inflated healthcare costs and erroneous reimbursements.