Integrated Medical Bill Review Risk Management

Integrated Medical Bill Review and Subrogation Integrated medical bill review combines silos into one solution.  This article provides a summary of various strategies to determine the value of medical bills. Plaintiffs in…

Continue Reading Integrated Medical Bill Review Risk Management
Opinion : Clinical Decision Support is not for Advertising
PracticeFusion designed rules based on patient specific clinical contexts to display advertising to care providers to attempt to influence their choices and received kickbacks

Opinion : Clinical Decision Support is not for Advertising

Practice Fusion Perverted the Intent of Key Patient Safety Measures in Clinical Decision Support in its Electronic Health Record Software According to publicly available sources on the U.S. Department of…

Continue Reading Opinion : Clinical Decision Support is not for Advertising
Medicare Skilled Nursing Facility Billing Changes for 2020
Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update

Medicare Skilled Nursing Facility Billing Changes for 2020

Effective January 1, 2020, with an implementation date of January 6, 2020, the Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing…

Continue Reading Medicare Skilled Nursing Facility Billing Changes for 2020
Medicare Local Coverage Determinations Create Inconsistency in Medicare Coverage
Medicare administrative contractors (MACs) and the Centers for Medicare & Medicaid Services (CMS) sometimes develop policies to limit Medicare coverage of specific items and services. MACs issue local coverage determinations (LCDs) that limit coverage for a particular item or service in their jurisdictions only. This can lead to State-by-State variation in Medicare coverage for similar items and services.

Medicare Local Coverage Determinations Create Inconsistency in Medicare Coverage

Medicare Local Coverage Determinations (LCDs) are inconsistent and cause uneven access to care for Medicare beneficiaries based on arbitrarily geographic boundaries and jurisdictions, rather than on medical necessity. That is…

Continue Reading Medicare Local Coverage Determinations Create Inconsistency in Medicare Coverage
Medicare Part D Expert Witness
Medicare Part D and Medicare Part C Appeals Process is Essential Expert Witness Specialized Knowledge

Medicare Part D Expert Witness

A Medicare Part D Expert Witness should understand the differences between how Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part C are administered. Finding a Medicare…

Continue Reading Medicare Part D Expert Witness