Billing & Reimbursement

The Medicare incentive programs with which you and your medical practice are familiar will soon be no more.  As of January 1, 2017, these programs (including the Electronic Health Records
Continue Reading Are You Ready for the New Medicare Quality Payment Program? (Part 2): Basics of the MIPS and How to Qualify in 2017

Called by some the “King of Nursing Homes” for his many low-income nursing home patients in northeast Illinois, Dr. Venkateswara Kuchipudi was recently convicted for referring patients to Sacred Heart
Continue Reading Nursing Home Fraud Scam Results in Conviction for “King of Nursing Homes”

The Affordable Care Act (ACA) requires Medicare providers to return overpayments within 60 days of the date they are identified in order to avoid liability under the False Claims Act. 
Continue Reading CMS Finally Makes Reasonable Changes to 60-Day Overpayment Rule

Commercial payors are actively looking for ways to reduce payments to out-of-network providers.  One area of focus is discounts and waivers of patient copayments and deductibles by out-of-network providers.  In
Continue Reading Offering Discounts (or Waivers) of Coinsurance/Copayments to Patients as an Out-of-Network Provider