CMS Clarifies Medical Necessity Requirements
Share this page: On December 23, 2015, the Centers for Medicare and Medicaid Services (CMS) released a new instructional video describing their policies and procedures for establishing medical necessity of chiropractic care.1 The video was released on the heels of a...
Are Your Medicare Notes Functional?
Share this page: Many are seeing increased denials of care for medical necessity in Medicare. A closer look at the reasons for the denials reveals a change in Medicare’s interpretation of medical necessity and progress in care. The evolution of their interpretation...
Provider Risk in ICD-10
Share this page: On July 7, 2015, the acting administrator for the Centers for Medicare and Medicaid Services (CMS), Andrew M. Slavitt, sent out a notice to all providers that CMS would be lenient in processing of the claim forms as long as provider’s codes are in the...
Why is the Discount Challenge prize amount $11,181? Because that is the average “per-occurrence” fine for Medicare inducements. That’s not $11,181 per patient, that’s not per provider, that’s PER VISIT. Stinks, doesn’t it? To us, the prize amount is worth the investment if we can help our profession better understand proper discounting.