Many are seeing increased denials of care for medical necessity in Medicare. A closer look at the reasons for the denials reveals a change in Medicare’s interpretation of medical necessity and progress in care. The evolution of their interpretation actually complements what chiropractors have been saying for several years – we do not only treat pain!
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The Centers for Medicare and Medicaid Services (CMS) has recently released its final rule indicating implementation of ICD-10 will occur on October 1, 2015.
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Like all Illinois corporations and medical corporations, professional service corporations must prepare and adopt by-laws (although they are internal documents and not filed with the state).
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More and more providers are feeling the effects of high deductible health plans when it comes to reimbursement and patient collections. Although the Affordable Care Act has lowered uninsured rates in the U.S. from 15.7% in 2009 to 9.1% in 2015[1], the number of patients delaying needed healthcare continues to rise as more of the cost-sharing has shifted from government and third-party payers back to the patient.
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The struggles of treating Medicare patients varies from low reimbursement rates to when a patient should sign the ABN form.
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Chiropractors across the country have been opening up their mailboxes to find audit letter(s) from Medicare. Although consultants have preached an increase in audits within the profession for years, many chiropractors were shocked to be the recipient of such a letter. You may be wondering why so many are being audited and what to do if you receive an audit letter at your office.
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On December 23, 2015, the Centers for Medicare and Medicaid Services (CMS) released a new instructional video describing their policies and procedures for establishing the medical necessity of chiropractic care.1 The video was released on the heels of a new study released by the Office of Inspector General (OIG), “CMS Should use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services”2, which revealed extrapolated data suggesting fraud and abuse in chiropractic Medicare utilization.
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Vertigo affects 35% of U.S. adults over 40, with BPPV being a common cause of dizziness. Accurate diagnosis and treatment are crucial for managing this condition effectively.
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