Understanding the Difference Between Medical Necessity and Medical Care
Published: Thu, 04/22/21
Understanding the Difference Between Medical Necessity and Medical Care The term “medical necessity” is used far and wide in medical care. But medical…
Medical Coding Pro
Medical Coding practice exams and exam preparation tools and information
Is the doctor in? Improve nursing homes with one easy stroke
Published: Fri, 04/16/21
Is the doctor in? Improve nursing homes with one easy stroke Many nursing home COVID-19 patients would have benefited from daily, reimbursed-for…
CMS Releases First Payment Rules for FY 2022
Published: Tue, 04/13/21
CMS Releases First Payment Rules for FY 2022 The Centers for Medicare & Medicaid Services (CMS) has issued its first proposed payment rules under the…
5 Use Cases for AI in Behavioral Health Practices
Published: Wed, 03/31/21
5 Use Cases for AI in Behavioral Health Practices With dwindling provider availability and a growing patient population, the healthcare industry is…
Top Challenges, Opportunities of Medical Coding and Billing
Published: Mon, 03/29/21
Top Challenges, Opportunities of Medical Coding and Billing By April of last year, seemingly every news station in American was featuring the heroic…
A Novel Approach to Defending Technical Denials
Published: Tue, 03/23/21
A Novel Approach to Defending Technical Denials For years, providers have been plagued with defending claims for medically necessary services that…
Integrating COVID-19 into Coding and Clinical Documentation Integrity
Published: Mon, 03/15/21
Integrating COVID-19 into Coding and Clinical Documentation Integrity Understanding how to clinically validate sepsis and differentiate between sepsis…
Skilled Nursing Facility Staffing Impacted by New Payment Rules
Published: Wed, 03/10/21
Skilled Nursing Facility Staffing Impacted by New Payment Rules Skilled nursing facility (SNF) staffing levels across several provider types have…
OIG: Hospitals are upcoding severity levels for Medicare patients
Published: Tue, 03/02/21
OIG: Hospitals are upcoding severity levels for Medicare patients A new report from the Department of Health and Human Services' Office of the…
Death of the Inpatient-Only List is NOT the Death of Medical Necessity
Published: Fri, 02/26/21
Death of the Inpatient-Only List is NOT the Death of Medical Necessity For readers of and listeners to RACmonitor and Monitor Mondays, overthinking…