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Latest articles

Provide Proof of a Qualified Professional with QPro!
August 1st, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS

QPro - Announces the Launch of an Innovative Testing Site! Innovation is paving the way once again! Unlike other certification bodies, QPro does not certify the ability to pass a test but instead verifies members qualifications are proven. Test online using real-life coding resources and coding books commonly used in the office setting. Who can Benefit ...

CMS Proposes Changes to Evaluation & Management Requirements
July 25th, 2018 - Wyn Staheli, Director of Research

It is no secret that providers have long argued that E/M coding is burdensome and does not truly reflect the services provided. This fact is acknowledged by CMS with the following statement "Prior attempts to revise the E/M guidelines were unsuccessful or resulted in additional complexity due to lack of ...

Patients Over Paperwork?! We have Great News!
July 18th, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS

Spend more time with patients and less time documenting? Great Concept! Document meaningful information? Sound good? CMS is proposing just that! CMS released a new proposal July 12, 2018, focused on streamlining clinician billing and expanding access to high-quality care. The goal is to improve and restore the doctor-patient relationship, modernize Medicare ...

Understanding the Level of Preventative Services (Grades and Suggestions)
July 17th, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS

It is essential for providers, clinicians, and other users to understand the importance of providing preventative services. The U.S. Preventative Services Task Force (USPSTF) has recommendations and has applied Grade Definitions as a suggested resource to imply the significance and strength of preventative services. The following definitions apply to recommendations ...

Attention Providers - Please Make Time to Read this Letter
July 17th, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS

In an effort to show CMS is committed to changing the rules to accommodate their providers CMS released a letter to Doctors of Medicare Beneficiaries. The letter offers encouragement and a promise to reduce the burden of unnecessary rules and requirements. The letter states “President Trump has made it clear that ...

Editors choice articles

Patients Over Paperwork?! We have Great News!
July 18th, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS

Attention Providers - Please Make Time to Read this Letter
July 17th, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS

Dual Medicare-Medicaid Billing Problems
July 12th, 2018 - Wyn Staheli, Director of Research

It is important to keep in mind that Medicaid is run at a state level so there can be some differences when it comes to coverage. However, the rules regarding balance billing of covered services is set at the federal level. The law states (emphasis added): A state plan must provide ...

The Money in MIPS
June 15th, 2018 - Diana Strubler

Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), recently announced that 91% participated in the first year of the Quality Payment Program (QPP), barely squeaking by their goal of 90%....

Health Care Fraud - Don’t Do It!
July 31st, 2017 - Chris Woolstenhulme, CPC, CMRS

If you wonder if what you are doing is fraud, DON’T DO IT! The government takes this extremely serious. I don't need to tell you this. I have often been apprehensive about making a mistake and I wonder, will it be fraud? Will I spend time in jail for accidentally sending in a duplicate ...