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Certificates Gone but Not Forgotten

CMS is discontinuing certificates for medical necessity and durable medical equipment. CMS is discontinuing Certificates of Medical Necessity and Durable Medical Equipment (DME) information forms

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No Surprises Act Surprises No One

Although the Biden Administration claims this is the final regulation, there is evidence more is yet to come. The Biden administration released the final No

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Understanding Updated RAC ADRs

New changes impact the ADR limits for RACs. The Centers for Medicare & Medicaid Services (CMS) has modified the additional documentation request (“ADR”) limits for

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My Patient is Bad – Very Bad

Ensuring your documentation meets medical necessity standards In 2003, the Centers for Medicare & Medicaid Services (CMS) made a change within the Claims Processing Manual

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How to Approach ED Claim Denials

Issues abound in prominent payer coding guidance. By now, many hospitals have received denials for emergency department level-of-care coding. We could legitimately ask, “how did

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