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Select the title to see a summary and a link to the full article.

Are Diagnoses from Telehealth Services Eligible for Risk Adjustment?

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On April 10th, CMS released a memo with the subject line, “Applicability of diagnoses from telehealth services for risk adjustment,” suggesting there may be some telehealth services that might not qualify for risk adjustment. However, in the memo CMS states: “Diagnoses resulting from telehealth services can meet the risk adjustment face-to-face ...

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Additional Telehealth Changes Announced by CMS

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On April 30, 2020, CMS announced additional sweeping changes to meet the challenges of providing adequate healthcare during this pandemic. These changes expand the March 31st changes. The article covers some of the key changes. See the official announcement in the references below.

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SOME of Us Non-Essentials May be Able to Get Back on the Road!

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The day is coming when the freeways will have 5:00 pm stop-and-go traffic again, no doubt. However, when it comes to re-opening our world, CMS has Recommendations! Changes are finally here; we are starting to see a decline in COVID-19 cases in some states and certain locations. It may be time ...

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Now That is Fraud! Genetic Testing "Public alert"

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Genetic testing is becoming very popular. In fact, so popular you might see it in places you would not expect such as a community event, fairs or any event happening in your community. Some labs may even offer FREE screening for genetic testing. Watch for FREE screening announcements or advertisements ...

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CMS Important Information on COVID-19 Released

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CMS has recently released some important information on their last MLN, the highlights are below. COVID-19: Dear Clinician Letter CMS posted a letter to clinicians that outlines a summary of actions CMS has taken to ensure clinicians have maximum flexibility to reduce unnecessary barriers to providing patient care during the unprecedented outbreak ...

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CMS Announces Final 2021 HCC Risk Adjustment Changes

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On April 6, 2020, the Centers for Medicare & Medicaid Services (CMS) published their final Medicare Advantage (MA) and Part D payment methodologies for CY 2021. Read more to be prepared for these upcoming changes.

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2020 Medicare Part D Coverage Gap (AKA donut hole)

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Not every Medicare drug plan has complete coverage for prescription drugs - most have some sort of coverage gap, known as the “Donut Hole”. The coverage gap is a temporary limit on coverage under the drug plan. This coverage gap will not affect everyone and begins after you have used ...

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Medicare Part D Coverage Gap (Donut Hole) Closes in 2020

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Overview of the Part D coverage gap, how it got closed, what the picture looks like for 2020, and long-term outlook.

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2021 Brings Another Risk Adjustment Calculation Change

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In 2021, a big change in Risk Adjustment score calculations will take place, which will affect payments to Medicare Advantage (MA) plans for the coming year and take us closer to quality and value-based programs instead of fee-for-service (FFS) or risk-adjusted (RA). Currently, CMS pays a per-enrollee capitated...

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Medicare Begins Covering Acupuncture Services

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Medicare is changing their policy regarding coverage of acupuncture, but in order to provide these services, you must follow their rules.

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Medicare Announces Coverage of Acupuncture Services

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On January 21, 2020, a CMS Newsroom press-release read, This new announcement is both exciting and refreshing. Acupuncture, a key component of traditional Chinese medicine and most commonly used to treat pain, is now being officially recognized by Medicare and several other large payers as a covered, alternative treatment option for ...

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Denials due to MUE Usage - This May be Why!

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CMS assigns Medically Unlikely Edits (MUE's) for HCPCS/CPT codes, although not every code has an MUE. MUE edits are used to limit tests and treatments provided to a Medicare patient for a single date of service or for a single line item on a claim form. It is important to understand MUE's are ...

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CMS Report on QPP Shows Increasing Involvement

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MIPS 2018 participation increased according to the final report issued by CMS on January 6, 2020.

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Time Is Up! Jan 1 2020 Claims Will be Denied Without MBIs

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New Medicare Card Transition Ends Next Week: Claim Reject Codes Beginning January 1 If you want to get paid you should be reporting MBIs on all of your Medicare claims. The deadline is here: if you are not using Medicare Beneficiary Identifiers (MBIs) on claims (with a few exceptions) after January 1, ...

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CMS- Patient Driven Payment Model Effective October 01, 2019

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According to CMS, In July 2018, CMS finalized a new case-mix classification model, the Patient-Driven Payment Model (PDPM), that, effective beginning October 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for classifying SNF patients in a covered Part A stay. Using the new Patient-Driven ...

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CMS says Codes are on the Move!

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Have you noticed your LCDs are missing something? CMS is moving codes out of LCDs and into Billing and Coding Articles. MACs began moving ICD-10-CM, CPT/HCPCS, Bill Type, and Revenue codes in January 2019, and will continue through January 2020. Therefore, if there is an LCD with its codes removed, you will find ...

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Q/A: Can I Order a TENS unit for a Medicare Patient?

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Question Can a chiropractor order a TENS unit for a Medicare patient? We cannot order X-rays for a Medicare patient so I assume we cannot order a TENS unit either. Answer It’s not that you can’t order the TENS unit, it’s just that when it comes to doctors of chiropractic, Medicare only covers ...

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And Then There Were Fees...

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Find-A-Code offers fees and pricing for just about everything, this article will address two of some of the most common payment systems with CMS. (OPPS) -Outpatient Medicare Outpatient Prospective Payment System. (MPFS)- Medicare Physician Fee Schedule The Fees section on each code page is determined on the type of services...

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Why is HIPAA So Important?

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Why is HIPAA So Important? Some may think that what they do to protect patient information may be a bit extreme. Others in specialty medical fields and research understand its importance a little more. Most of that importance lies in the information being protected. Every patient has a unique set of ...

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Are You Aware of Medicare Advantage Plans Timely Filing Rules?

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The Medicare Fee for Service (FFS) program (Traditional or Original Medicare) has a timely filing requirement; a clean claim for services rendered must be received within one year of the date of service or risk payment denial. As any company who has billed Medicare services can attest, the one-year timely filing ...

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Will Medicare Change Their Rules Regarding Coverage of Services Provided by a Chiropractor?

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Two separate pieces of legislation introduced in the House of Representatives (H.R. 2883 and H.R. 3654) have the potential to change some of Medicare’s policies regarding doctors of chiropractic. Find out what these two bills are all about and how they could affect Medicare policies.

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The Slippery Slope For CDI Specialists

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Who knew that when Jack & Jill when up the hill to fetch a pail of water, they would have to ensure that in order to keep the level of water the same on the way back down, they would need to both support the pail.  Many of you in this industry are ...

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Anthem is Changing their Timely Filing Requirements for All Plans, Including Medicare Advantage

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Anthem has been very busy sending out notices stating that, beginning October 1, 2019, all timely filing deadlines for claims will be 90 days. We've seen this letter, or something very similar, sent to doctors and other healthcare providers from California to Kentucky. In their notice, Anthem states: "Effective for all commercial ...

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Helping Others Understand How to Apply Incident to Guidelines

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Over the past few months, I have worked with different organizations that have been misinterpreting the "incident to" guidelines and, in return, have been billing for services rendered by staff that are not qualified to perform the services per AMA and CPT. What I found within the variances is that ...

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A United Approach

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A United Approach As auditors, we all have a different perspective when evaluating documentation. It would be unreasonable to think that we all view things the same way. In my opinion, differing perspectives are what makes a great team because you can coalesce on a particular chart, work it through and ...

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Now is Your Chance to Speak Up! Tell CMS What You Think!

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CMS is asking for your input, we all have ideas on how we would change healthcare documentation requirements and get rid of the burdensome requirements and regulations if it were up to us, so go ahead, speak up! Patients over Paperwork Initiative is being looked at to help significantly cut ...

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Medicare Revises Their Appeals Process

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On April 12, 2019, Medicare announced that there will be some changes to their appeals process effective June 13, 2019. According to the MLN Matters release (see References), the following policy revisions in the Medicare Claims Processing Manual (MCPM), Chapter 29 are taking place: The policy on use of electronic signatures Timing ...

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Medicare Revises Their Appeals Process

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There are policy revisions in the Medicare Claims Processing Manual (MCPM), Chapter 29 taking place June 13, 2019. This will give you a heads up on those changes.

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Auditing Chiropractic Services

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Chiropractic is unique from other types of health care and auditors need to be aware of the nuances of this field. Chiropractic has become the focus of more and more audits as doctors seem to struggle to create records that properly support the care provided to the patient throughout the entire episode.

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Q/A: What do I do When a Medicare Patient Refuses to Sign an ABN?

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Question: What do I do when a Medicare patient refuses to sign an ABN? Answer: That depends on whether the patient is still demanding to have/receive the service/supply. If they aren’t demanding the service, then there is no need to force the issue. Just make sure that you still have an ...

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Q/A: Can I Tell a Medicare Patient Which Option to Check on the ABN?

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Question My patient seemed confused about which of the options they should check. Can I just tell them which one they should check? Answer No! That could be construed as coercion. The official instructions state “Under no circumstances can the notifier decide for the beneficiary which of the 3 checkboxes to select.” Now, this ...

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Clearing Up Some Medicare Participation Misunderstandings

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Even though we may think we truly understand what it means to be a participating provider, Medicare doesn’t quite work the way that other insurance plans do. Far too many providers do not understand the difference and get into hot water. To further complicate matters, the rules are different for ...

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Date of Service Reporting for Radiology Services

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Providers need to ensure that they are reporting radiology dates of service the way the payer has requested. Unlike other many other professional services which only have one date of service (DOS), radiology services can span multiple dates. Medicare requirements may differ from professional organization recommendations.

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Q/A: Can you Help me Understand the New Medicare Insurance Cards?

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As many of you are aware, CMS began issuing new Medicare identification cards last year which required the replacement of social security numbers with a new Medicare Beneficiary Identifier (MBI). All cards have now been mailed out and patient's should have the new cards when they come in. Currently, we are in the transition period until January 2020.

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Coding Medicare Initial Preventive Physical Exams (IPPE)

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The Medicare Initial Preventive Physical Exam (IPPE), also commonly referred to as the “Welcome to Medicare Physical”, may seem daunting to many, but when broken out to identify the requirements is fairly straightforward. Purpose An IPPE helps the Medicare beneficiary (the patient) get to know their healthcare provider at a time when they ...

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HHS Proposes Significant Changes to Patient Access Rules

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In a significant announcement on February 11, 2019, HHS proposed new rules aimed at improving interoperability of electronic health information. This announcement was made in support of the MyHealthEData initiative which was announced by the Trump administration on March 6, 2018. The goal of that initiative was to break down ...

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Charging Missed Appointment Fees for Medicare Patients

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Some providers mistakenly think that they cannot bill a missed appointment fee for Medicare beneficiaries. You can, but Medicare has specific rules that must be followed. These rules are outlined in the Medicare Claims Policy Manual, Chapter 1, Section 30.3.13. You must have an official “Missed Appointment Policy” which is ...

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Attestations Teaching Physicians vs Split Shared Visits

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Physicians often use the term "attestation" to refer to any kind of statement they insert into a progress note for an encounter involving work by a resident, non-physician practitioner (NPP), or scribe. However, for compliance and documentation purposes, "attestation" has a specific meaning and there are distinct requirements for what ...

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Empowering Medicare Beneficiaries

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BLOG: CMS announced a NEWS release today making it easier to help Medicare Beneficiaries access cost and quality information. CMS announced,  "Today, the Centers for Medicare & Medicaid Services (CMS) launched a new app that gives consumers a modernized Medicare experience with direct access on a mobile device to some of ...

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Home Oxygen Therapy

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Home Oxygen Therapy Guidelines

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CMS Finalizes Major Changes to ACO Program

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Back in August of 2018, as part of the Medicare Shared Savings Program (Shared Savings Program), CMS proposed some sweeping changes for Accountable Care Organizations (ACOs). There has been some controversy over these changes which require ACOs to move to two-sided models. In this Final Rule which was scheduled to be published in the Federal Register ...

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Select the webinar title to view a summary and link to the webinar video.

Proving Medical Necessity and Functional Improvement

Medicare is required by law to pay for care that is medically necessary. Medicare considers functional improvement to be the primary indicator of medical necessity for chiropractic care. It is up to you, the doctor, to prove functional improvement and medical necessity with your documentation. Dr. Short will show you how to use common practice tools to document functional improvement, medical necessity and maximum medical improvement.

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Expanding Chiropractic Coverage in Medicare

Currently Medicare only pays for the adjustment and then only when it is used to correct a subluxation. This injustice within the Social Security Act needs corrected. Dr. Ron Short will discuss the Medicare laws as they relate to chiropractic and what changes need to be made and why. ...

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Chiropractic Manipulative Treatment and Medicare - Part 2

In this CE webinar, Dr. Gwilliam will continue his discussion from the webinar delivered Dec. 18 about chiropractic manipulative treatment. But this time, it is all about Medicare. If you don't treat Medicare beneficiaries, you should probably listen anyway. Usually whatever Medicare wants is the same thing as all the other payers. Find out the difference between acute, chronic, and maintenance, as well as when to use certain modifiers.

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Medicare Reviews

Medicare continues to increase their efforts to review doctors and recover “overpayments”. This increases the likelihood that your notes will be reviewed and that you will be required to pay money back to Medicare. In this webinar Dr. Short will show you:  Why you should appeal every adverse decision.  How to appeal adverse decisions.  What information you need in your documentation for an effective appeal.  How to structure your appeals to be most effective.

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How to Create a Medicare Compliance Plan

In this webinar, Dr. Marty Kotlar (certified coding and compliance expert) will discuss how to create an OIG/Medicare compliance plan. He will explain how to create policies, how to perform a "self-test" on your SOAP notes, search the Medicare exclusions list, Stark, anti-kickback and how to handle compliance concerns.

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Medicare Reviews

Medicare reviews claims for a variety of reasons. Some are routine and are not a problem for the doctor or the practice. Some are investigatory in nature and indicate a serious potential threat for both the doctor and the practice. Dr. Ron Short will go over the types of reviews and which are routine and which should cause you to lose sleep. In this webinar you will learn: -What routine reviews are and why they are conducted -What reviews are a potential risk -What triggers reviews -When to get help and what kind of help to get

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Risky Business

This presentation will review how risk management is no longer limited to just malpractice claims. It also includes your financial policy. There is now a greater risk of financial loss due to improper discounting and faulty financial and collection policies than ever before. It is widely known that the Office of Inspector General (OIG) and Medicare are cracking down on healthcare fraud and abuse, but what most chiropractors are unaware of, is how widely successful these efforts have been. In this presentation, we will identify the five most dangerous things we face in chiropractic and how to avoid them. All attendees will receive a free sample 1-page financial policy that can be customized for their practice and a link to receive a free risk assessment score for their practice.

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Modifications to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program for 2014 and Other Changes to the EHR Incentive Program; and Health InformatMedicare Appeals - by CMSMedicare as Secondary PayerMedicare Benefit Policy Manual, Chapter 15 (also known as Medicare Carriers Manual)Medicare Claims Processing Manual - Chapter 25Medicare Claims Processing Manual Chapter 7 - SNF Part B BillingMedicare Claims Processing Manual, Chapter 12Medicare Claims Processing Manual, Chapter 29 - Appeals of Claims DecisionsMedicare Claims Processing Manual, Chapter 9 - Rural Health Clinics/Federally Qualified Health CentersMedicare Compliance Manual 2018Medicare Coverage and Payment of Virtual ServicesMedicare Coverage for Skilled NursingMedicare Enrollment and Claim Submission GuidelinesMediCare Enrollment Appication CMS-855BMEDICARE ENROLLMENT APPLICATION Institutional Providers CMS-855AMedicare Learning Network - Chiropractic ServicesMedicare Manual - Chapter 5 – Items and Services Having Special DME Review ConsiderationsMedicare Medical Savings Account (MSA) Plans - by CMSMedicare Mental Health Services booklet by CMSMedicare OverpaymentsMedicare Part A for Skilled NursingMedicare Provider Enrollment Application InformationMedicare Provider-Supplier Enrollment - by CMSMedicare Reconsideration RequestMedicare Recovery Audit by HHS Office of the Inspector GeneralMedicare Redetermination RequestMedicare Removes SSN from Medicare Cards - Press ReleaseMedicare Secondary Payer fact sheet by CMSMedicare Shared Savings Program (MSSP) Requiremenst for ACOs - by ACAMedicare Topics PageMedicare Topics Page - ChiropracticMedicare, Overpayments, FraudMedicare: To Participate or Not to Participate?Medicare’s Vision Services Fact SheetMisinformation about Chiropractic Services - by Medicare Learning NetworkMLN ConnectsMLN Matters: Cataract Removal with Medicare Part BMLN Matters: MPPR on the TC of Diagnostic Cardiovascular and Ophthalmology ProceduresMLN Matters: Presbyopia-Correcting Intraocular LensesMLN: Medicare Vision Services Fact SheetModifier 50 UsageNational Medicaid Audit Program fact sheet - by CMSNCCI Instructions for Modifier 59Noridian Documentation ChecklistsNoridian: Ambulance ResourcesNovitas - Specialty Exam Score SheetsNPI RegistryOffice of Inspector General: Questionable Billing for Medicare Ophthalmology Services 2012Online Research ToolsOpting out of Medicare and/or Electing to Order and Refer Services - MedLearn articleOverview of Mandatory Complinace ProgramPalmetto GBAParticipating vs. Non-Participating (Medicare Part B Claims)PECOSPhysician Payment WebsitePQRS Analysis and Payment by CMSPress release: New CMS rule allows flexibility in certified EHR technology for 2014Q&A on Skilled Nursing Facility Consolidated BillingQuality Care ManagementQuality Measures for MIPS by CMSQuality Payment ProgramQuality Payment Program Fact Sheet by CMSReminder to Stop Billing Duplicate Claims by Medicare Learning NetworkScreening Pap Tests and Pelvic Examinations by CMSSkilled Nursing Facility Best Practice GuidelinesSkilled Nursing Facility Consolidated BillingSkilled Nursing Facility Education and TrainingSpecial Advisory Bulletin, Offering Gifts and Other Inducements (2002) - by the Office of the Inspector General (OIG)Special Advisory Opinion 12-21 , Offering Gifts and Other Inducements (2013)- by the Office of the Inspector General (OIG)Summary of 2015 Physician Value-based Payment Modifier PoliciesThe CMS eHealth InitiativeThe Medicare Program Integrity Manual, Chapter 3, Section 3.4.1.1 BTimely Claims Filing: Additional Instructions - MedLearn Article by CMSUseful Medicare siteWPS Medicare how do they price Non-ASP New drugs and NOC Drugs?Your Guide to Who Pays First - by CMS




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