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Health Care Providers › Medical Billing Codes › Billing

J.S. Held

Inside the Healthcare Industry: The Critical Role of Medical Coding, Billing & Nurse Review

J.S. Held on

In what is already a highly regulated industry, it is becoming increasingly difficult for healthcare organizations to navigate the growing volume, complexity and enforcement of laws, regulations and guidance that surround...more

Health Care Compliance Association (HCCA)

Compliance with Medicare’s updated 2024 split (or shared) visit policy

Health Care Compliance Association (HCCA) on

Split (or shared) visits—the current term used by the Center for Medicare & Medicaid Services (CMS)—allow non-physician practitioners (NPPs) and physicians who work for the same employer/entity to share patient visits on the...more

Husch Blackwell LLP

Physician Loses Rare Criminal E/M Fraud Trial

Husch Blackwell LLP on

Evaluation and management (E/M) services have been called “the core” of healthcare billing. E/M is a catch-all claim, allowing medical professionals to bill for diagnosing or treating nearly any illness or injury. E/M is also...more

Oberheiden P.C.

Medicare TPE Audits: 7 Common Questions Answered

Oberheiden P.C. on

The Centers for Medicare and Medicaid Services (CMS) and its audit contractors have recently increased their use of Targeted Probe and Educate (TPE) audits to target providers suspected of improperly billing Medicare. While...more

Nelson Mullins Riley & Scarborough LLP

Increased Enforcement Activity Expected Relating to Healthcare Provider Billing Upcoding

Nelson Mullins Riley & Scarborough LLP on

A pair of recent reports issued by the Health and Human Services Office of Inspector General (“OIG”) and Cotiviti, a Centers for Medicare and Medicaid Services (“CMS”) Recovery Audit Contractor (“RAC”), indicate a resumed...more

King & Spalding

California Court of Appeal Decision Highlights Importance of Technical Details in Billing Practices and Managed Care Agreements

King & Spalding on

Hospitals and other health care providers work hard to eliminate billing and coding errors, but mistakes still happen. When those mistakes occur, health plans sometimes try to capitalize on the error by using it as a basis to...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 25th Annual Compliance Institute - April 19th - 22nd, 9:30 am - 4:35 pm CDT

Health Care Compliance Association (HCCA) on

The Compliance Institute is celebrating 25 years! Join us for the Compliance Institute's 25th anniversary, April 19-22, 2021. This year, HCCA is excited to celebrate over two decades of compliance excellence with our...more

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