In the wake of the COVID-19 pandemic, the behavioral health industry finds itself under an intensified magnifying glass, with notable increased interest and activity from the Private Equity community and consolidation in the behavioral health space, it’s no...
Increasing Government Oversight Continues for Risk Adjustment (HCC) Coding Compliance
Risk Adjustment (HCC) coding compliance is quickly becoming the forefront of primary care across the nation as value-based care models continue to be implemented within the healthcare industry. With the added administrative burden placed upon providers and...
Three Options for Medical Practices in Today’s Disruptive Financial Climate
The healthcare industry, and physician practices in particular, are experienced at weathering industry disruptors and a landscape that seems to be in perpetual change. However, the last few years have seen a notable increase in mergers and acquisitions, with all...
Healthcare Highlights from the Presidential Proposed FY24 Budget
President Biden released his proposed FY2024 budget at the beginning of March. Though the budget must still clear the hurdle of Congressional approval, its final version is likely to have significant impact on health care organizations. The proposed changes cast a...
2023 CPT Coding Changes
The following is a synopsis of the major changes to CPT that will take effect January 1, 2023.
Significant Evaluation and Management Coding Changes Again on The Horizon
In 2021, the American Medical Association implemented significant changes to the Evaluation and Management (E/M) code sets applicable in the office/outpatient setting. Those changes, which were intended to simplify coding by placing more emphasis on complexity and...
Challenges of Finding and Retaining Talent for Private Practices
As we have seen since April 2021, we are still being influenced by the Great Resignation or the Big Quit. COVID-19 was a wake-up call for many people in general, but even more so for employees who were not satisfied with their current roles in the workplace. Employees...
Coding Changes – 2023 Here We Come!
The most recent significant changes to the E&M coding guidelines occurred in 2021 allowing physicians to choose between medical decision-making and time-based reporting for their services. Now, it appears we are in store for additional changes to begin January...
Coding audits 101: How physicians can prepare
You’ve received a request for medical records from a payer, who is going to conduct an audit on your claims. Your Electronic Health Record (EHR) system is excellent, the notes are voluminous, your providers are well-versed at coding. If anything, you under code! You...
2021 Reflections
These are recaps of what they report as some of the trends and realities of compliance today