Inside Angle

From 3M Health Information Systems

Tag: medical necessity

Blog Post

Focus on E/M services: Medically appropriate history and exam

December 4, 2020 / By Jean Jones, CPC

So far in our Evaluation and Management Services blog series, we have gone over changes related to medical decision making (MDM), specifically changes to the first, second, and third elements. […]

Blog Post

The importance of medical necessity compliance: Recent actions by the U.S. Attorney’s Office and the OIG

July 16, 2018 / By Barbara Aubry, RN

I’ve been talking about this for years. I still see folks who don’t think compliance with medical necessity polices is critical. Believe me, I understand human nature; noncompliance can be […]

Blog Post

Mammograms and Modifier 52

February 12, 2018 / By Barbara Aubry, RN

In late December 2017, I was asked by a colleague for my opinion on a customer’s inquiry about modifier 52 and its use in mammograms. CPT® modifier 52 represents a […]

Knowledge Lab Post

Case Study: Children’s Medical Center – Dallas

With 65 percent of the patient population under Medicaid, Children’s Medical Center in Dallas knew they had to find ways to improve their case mix.

Knowledge Lab Post

eGuide: Delivering value-added software to your EHR’s revenue cycle and analytic workflows

Effective revenue cycle workflows often depend on supplemental third-party software to fully manage regulatory and payment requirements. What’s missing from your outpatient revenue cycle system?

Knowledge Lab Post

Infographic: The complexities and costs of medical necessity

Do you know how many of your weekly claims need rework due to noncompliance with medical necessity rules? Get the big picture in this infographic.

Preview

Knowledge Lab Post

Case Study: Kettering Health Network

After experiencing an increased rate of claims denials, Kettering took action and now has a clean claim rate of 96 percent and bill holds averaging one to three accounts per […]