E/M Coding Updates Podcast

E/M, CPT Code, & Documentation Updates for 2021 – CMS & AMA Come Together to Benefit Providers

Cindy Groux, CHBME/Board Member at HBMA and CEO, President and Owner of Health Care Practice Management, will address new CPT codes for 2021 to include prolonged services and clinical staff services, documentation changes to reduce the administrative burden, decreased needs for audits and how to promote coding consistency, and new rules for time billing.

New Stark AKS Podcast

The New AKS and Stark Laws Final Rules Key Take Aways

Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents on these new updates. On November 20, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule related to the Medicare Physician Self-Referral Law (Stark Law). Nearly simultaneously, the Office of the Inspector General, Department of Health and Human Services (HHS-OIG), released a Final Rule, which amends various safe harbors to the Federal Anti-Kickback Statute (AKS). The changes appear to be based, in large part, on value-based healthcare delivery and payment systems. The purpose of this presentation is to highlight the key changes, along with the similarities and differences in the language between the two Final Rules.

Infographic: Healthcare Compliance Training for the Workforce

Successful employee education is an integral part of a comprehensive healthcare compliance program. Compliance professionals must consider which topics should be offered to the workforce. Of course, proper training depends on variables such as type of healthcare organization, roles of employees and location of the entity. States may impose specific requirements that go beyond federal requirements. Generally, four broad categories cover the topics imperative to the start of a comprehensive healthcare compliance program.

Appropriate Use Criteria: What you Need to Know

Catherine Short speaks with Melody Mulaik, President of Revenue Cycle Coding Strategies to address a current hot topic, “Appropriate Use Criteria: What you Need to Know.” 2021 is also going to be an official CMS testing year for AUC/CDS implementation. This episode will identify specific areas of concern for your organization regarding AUC/CDS implementation, help you to facilitate discussions with all stakeholders to ensure all perspectives are heard and addressed, and assist in designing actions that can be taken to facilitate a successful implementation to ensure revenue is not negatively impacted. 

Why payers can’t ignore the interoperability rules and should comply sooner rather than later

Catherine Short speaks with Dr. Chris Hobson, Chief Medical Officer for Orion Health. The topic of today’s program is “Why payers can’t ignore the interoperability rules and should comply sooner rather than later.” The Interoperability and Patient Access final rule approved by CMS and ONC is intended to advance patient participation through access to their health information and to drive advanced interoperability and innovation across the U.S. These rules will have significant impact on payer organizations who are currently facing unprecedented times.

Billing for Chronic Care Management: What Are the Problematic Issues?

Catherine Short speaks with Markus P. Cicka, J.D., LL.M. (Health Law), owner of the Law Office of Markus P. Cicka, LLC, a law firm based in Saint Louis, Missouri, about the topic of “Billing for Chronic Care Management: What Are the Problematic Issues?” We will discuss what is chronic care management, have an understanding of who exactly can bill for providing chronic care management services, and discover what are recent chronic care management billing issues that have been flagged by the OIG. 

CMS Compliance 2020

Understand CMS Changes to Compliance Training for Healthcare Providers under Medicare Advantage and Part D

Establishing and maintaining a well-designed compliance program is key to preventing, detecting, and mitigating noncompliance. The seven elements of an effective compliance program outlined in the Federal Sentencing Guidelines, sets the framework but there are additional requirements that need to be integrated into the compliance program in order to be effective.

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