Technical Resources for Medical and Radiation Oncology Practices
Staying connected to the industry trends and developments is important to your financial well-being. On this page you will find a compilation of helpful information covering topics such as Medicare fraud and abuse, compliance, ICD-10 basics, physician supervision and more. We provide these articles to keep you informed of the latest radiation and medical oncology news and regulations.
This CMS guide is intended for use as a reference tool on the documentation guidelines for evaluation and management (E/M) and the common codes used to bill for E/M services and service providers.
Medicare fraud and abuse cost taxpayers billions of dollars each year in addition to putting patients’ health at risk. In this document you will see examples of Medicare abuse, a review of the laws enacted to fight fraud and abuse and how to report suspected cases.
This CMS document serves as a guide for individual eligible professionals, group practices, Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) and Pioneer ACOs wanting to report quality measures once during the 2014 program year in order to become incentive eligible for the 2014 Physician Quality Reporting System (PQRS), avoid the 2016 PQRS payment adjustment and satisfy the clinical quality measure (CQM) component of the Electronic Health Record (EHR) Incentive Program. In addition, this document will provide necessary information regarding the 2016 Value-Based Payment Modifier (VM) adjustment for group practices.
In navigating requirements set by payors, practices and facilities find they’re able to reach their highest standard of documentation and billing compliance only by applying focused effort and dedicated resources. Though the importance of efficient, accurate processes seems obvious, it’s often overlooked or minimized in light of the resources it takes to implement them—money, staff and the ability to manage often unpopular policies—and achieve what should be the highest standard of care in today’s healthcare environment.
As more and more physicians transition to employment relationships with hospitals, they may ask, "Am I getting paid what I deserve?" With proper due diligence prior to joining the hospital, physicians can determine the answer to this potential question.
Would you risk your livelihood by taking shortcuts? In healthcare, taking unnecessary risks can put your practice—and potentially your patients' safety—in jeopardy.
This IMRT Reference List is a compilation of journal articles that could be utilized to support medical necessity for delivering IMRT treatments to anatomical sites whose diagnosis code is not covered under your LCD.
After a review of claims by Recovery Auditors, it was found that physicians and non-physician practitioners were incorrectly billing the number of units for Rituximab and Bevacizumab. In this article from the Medicare Learning Network(R), specific guidelines are given to accurately bill for these drugs.
With the impending implementation of ICD-10, this CMS article contains the latest information and resources available for healthcare providers.
In this current update, CMS is further clarifying the CY 2010 physician supervision policies in response to additional questions and comments received since publication of the final rules.
Cancer center design, whether hospital- or practice-based, requires the expertise and leadership of professionals who are highly experienced in not just the delivery of patient-focused clinical care but critical aspects of design and construction. Ultimately, space planning affects the quality of life of cancer patients and empowers everyone involved in helping healing thrive.
As a physician it is important to know and understand what qualifies as an "incident to" service. This article is designed to delve into the requirements needed to qualify as an "incident to" service and remain compliant with CMS standards.
As a provider, it is your responsibility to know when it is acceptable to use a rubber stamp instead of a handwritten or electronic signature. This article will detail the circumstances for acceptable use of a rubber stamp in lieu of a handwritten or electronic signature.
As a provider you may have many questions about signature documentation. What are the guidelines for using an electronic signature? What is required for a valid signature? What if I didn't sign an order or the medical record? This document, produced by the Medicare Learning Network, defines the specific requirements regarding a physician signature.
With the reported findings by the Office of the Inspector General that physicians and other suppliers frequently incorrectly report the POS in which they furnish services, this article clarifies the national policy for the correct assignment of POS codes.
This publication, as presented by the Medicare Learning Network, outlines payment and documentation guidelines for physician services in teaching settings. It also includes guidelines on evaluation and management (E/M) documentation for teaching physicians and residents.
This manual contains specific coding guidelines for drugs and biologicals used in both hospital and outpatient treatment facilities.
This document contains the Medicare claims processing coding guidelines specific to physicians and non-physician practitioners.
As a rural healthcare provider and supplier, there are some unique circumstances for billing specific services. This reference provides comprehensive rural billing information for each specific provider type including ambulance services, office visits, hospital services, radiology and diagnostics, clinical laboratory tests, supplies and drugs, and preventive services.
With the establishment of the State Medicare Rural Hospital Flexibility Program, certain facilities participating in Medicare are eligible to become Critical Access Hospitals (CAH). This document contains the requirements for CAH designation, CAH payment information and grants to states under the Medicare Rural Hospital Flexibility Program.