A Review of Mohs Surgery Claims with Incorrect Coding May Reveal Fraud
by Cindy Gallee, JD, RHIA, CHC There are a number of ways a dermatology claim for Mohs surgery can be…
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Context to Showcase FWA Solutions at NHCAA Conference in Dallas, TX
by Kate Armbruster Context4 Healthcare Inc. will showcase its Fraud, Waste & Abuse (FWA) solutions as an exhibitor at the National…
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Big Change This Fall! MUE Allows 2 E/M Codes Billed for the Same Day
by Margaret Klasa DC, APN BC In the past, Medicare has allowed only one Evaluation and Management (E/M) visit per…
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Why Quashing Kwashiorkor Overpayments is a Good Lesson for Any Payer
by Cindy Gallee, JD, RHIA, CHC If you are seeing claims for the treatment of Kwashiorkor, you may want to…
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Tips to Modify Your Modifier Usage: Bundling & Unbundling Compliance
by Cindy Gallee, JD, RHIA, CHC “Unbundling” is a hot topic within the healthcare community and is considered fraudulent if…
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Context to Make a Splash as Exhibitor at SIIA Conference – Phoenix, AZ
by Kate Armbruster Context4 Healthcare will showcase its payer solutions as an exhibitor at the SIIA 34th Annual National Educational Conference &…
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Are Your Clinical Lab Drug Screenings Free From Fraud?
by Cindy Gallee, JD, RHIA, CHC Recently, a fraud scheme was uncovered in Virginia involving a substance abuse clinic and…
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The “X” Factor: 4 New Modifiers Will Define the Use of – 59 in 2015
by Margaret Klasa DC, APN BC On August 15, 2014, the Centers for Medicare & Medicaid Services (CMS) introduced four new Healthcare…
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Avoid Overpayment – Review Documentation for Outpatient Therapy Claims
by Cindy Gallee, JD, RHIA, CHC Outpatient physical therapy claims present an area that has long been fraught with the…
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Drugs Used to Treat HIV Have Become Targets for Fraud Investigations
by Cindy Gallee, JD, RHIA, CHC Antiretroviral drugs, used to treat Human Immunodeficiency Virus (HIV), have recently come under scrutiny…
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Context is on the Oregon Trail…to the Plexis 2014 Users Conference!
by Kate Armbruster Context4 Healthcare will showcase its FirstPass™ claim editing solution as an Integrated Partner exhibitor at the Plexis…
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Detect FWA Using Patterns in Procedure & Diagnosis Code Pairings
by Cindy Gallee, JD, RHIA, CHC Payers can detect fraudulent billing schemes by analyzing certain CPT codes that are used in conjunction…
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