Tag Archives: medical documentation

“Not-Assessments:” Misconceptions about Assessing Conditions

We educate a good bit about documentation of a proper assessment, use the acronyms M-E-A-T or T-E-A-M and still see skimpy notes with an “assessment” that doesn’t pass muster – from providers who, by now, should be on board with … Read Full Post

Tagged assessment, M-E-A-T, medical documentation |

Lessons from the Cigna/DOJ Lawsuit: Health Risk Appraisals (Part 2)

Last week’s first installment of this blog started our review of HRAs in the MRA environment. Let’s continue searching for lessons to apply in your practice. A third issue with Cigna’s HRAs was the supposed expectation to capture all the … Read Full Post

Tagged Cigna, cms, coding compliance, DOJ, HCC, health risk appraisal, HRA, medical coding, medical documentation, medicare advantage plans, medicare risk adjustment, mra, risk adjusted reimbursement |

Documentation for Risk Adjusted Payment

The concept of medical documentation has usually focused on those elements supporting the evaluation and management (E/M) code selection in fee-for-service payment environments; electronic medical records (EMRs) have done a great deal to alleviate the charting burden for these clinicians. … Read Full Post

Tagged charting, M-E-A-T, medical documentation, medicare risk adjustment, mra, T-E-A-M |

Lessons from the Cigna/DOJ Lawsuit: Health Risk Appraisals (Part 1)

This blog is the first in a series of lessons, or reminders, gleaned from the Department of Justice’s (DOJ) lawsuit against health insurer Cigna. The suit alleges that Cigna essentially committed fraud by reporting false information to CMS in a … Read Full Post

Reminders for Proper Documentation

We all know providers are stressed for time and want to provide the best medical care to each and every one of their patients even in a short window of time. Unfortunately, the first thing to suffer is the documentation … Read Full Post

Tagged cloned notes, combination codes, icd-10 codes, medical documentation, mra, patient assessment, templates |

What We’re Reading – Sometimes physician query is imperative

A staff member’s role is one of supporting the clinician. However, in the area of coding and billing, the perspective is more of collaboration as the employee must appropriately transfer the practitioner’s documentation into correct codes, advise him/her on the … Read Full Post

Tagged appendicitis, coding and billing, coding guidelines, medical documentation, medical necessity, pericarditis, query the physician, reimbursement |

How to Navigate the Medical Review Projects

Jurisdiction 11 Home Health and Hospice FAQs: Additional Medical Review Projects and CERT To help reduce the Comprehensive Error Rate Testing (CERT) program error rates, Palmetto GBA was recently funded by CMS to undertake additional medical review projects that involve … Read Full Post

Tagged adr letters, cert, claim denials, comprehensive error rate testing, home health billing, Imark consulting, medical documentation, medical review projects, palmetto gba |

What We’re Reading – Medicare Pilot Project for Electronic Submission of Medical Documentation

CMS is launching the Electronic Submission of Medical Documentation (esMD) pilot project for providers to submit medical documentation in electronic fashion when responding to requests from Recovery Audit Contractors. The new system is expected “to reduce provider costs and cycle … Read Full Post

Tagged cms, electronic medical record, electronic submission, esmd, medical documentation, pilot project, recovery audit contractors |