by Caroline Fife, M.D. | May 11, 2022 | Healthcare Payment Policy
The Office of the Inspector General (OIG) has released a report concluding what we clinicians already knew – that the prior authorization (PA) process of some Medicare Advantage Organizations (MAO) delays medically-necessary care that is covered under Medicare rules....
by Caroline Fife, M.D. | Apr 27, 2022 | Fight the Good Fight, Healthcare Payment Policy
Join me Friday June 10th for the Northwell Health conference “Shining the Light on Wound Care”. I will be speaking about the vascular origin of pressure injuries! Click Here to Register Download the Brochure Caroline Fife, M.D.Dr. Fife is a world renowned wound care...
by Caroline Fife, M.D. | Mar 8, 2022 | Healthcare Payment Policy
I’ve been the clinical editor for Today’s Wound Clinic for a long time and we’ve published many fantastic articles on topics ranging from the complex issues around reimbursement to the challenges of lymphedema management, including hyperbaric oxygen therapy and now...
by Caroline Fife, M.D. | Feb 25, 2022 | Fight the Good Fight, Healthcare Payment Policy
Check out Dr David Charash’s guest editorial in Today’s Wound Clinic about his Medicare TPE (Targeted Probe and Educate) audit focused on hyperbaric oxygen therapy! –Caroline Caroline Fife, M.D.Dr. Fife is a world renowned wound care physician...
by Caroline Fife, M.D. | Jan 21, 2022 | Healthcare Payment Policy
I’ve got some good news and some bad news. First, the Good News CMS (the Centers for Medicare and Medicaid Services) has approved 9 wound-care and hyperbaric medicine relevant quality measures for the 2022 reporting year. The quality measures were developed...
by Caroline Fife, M.D. | Nov 26, 2021 | Healthcare Payment Policy
Last week I enjoyed a relaxed, unscripted conversation with Dr. Helen Gelly about trends in wound care audits and charge denials, with a live audience Q&A. You can watch the recording of the conversation and Q&A below. You can also find the audio of this event...
by Caroline Fife, M.D. | Nov 17, 2021 | Healthcare Payment Policy
Friday, November 19th at 4:00PM EST Join a friendly, unscripted conversation between long-time friends and wound care industry influencers Dr. Caroline Fife and Dr. Helen Gelly as they discuss charge denial and audit trends affecting wound practices across the nation...
by Caroline Fife, M.D. | Oct 19, 2021 | Healthcare Payment Policy
I’ve mentioned that am a huge fan of Knicole Manuel. You should check out her latest blog post about Targeted Probe and Educate (TPE) audits. The various Medicare regions were hitting wound care and hyperbaric medicine physicians/hospitals hard with TPEs prior to...
by Caroline Fife, M.D. | Sep 30, 2021 | Healthcare Payment Policy, Tales of the Medicare Disadvantaged
Here’s a new post from our Patient Correspondent, Patricia Han, RN, about Medicare Drug Plans. She’s a retired nurse with many chronic health problems who used to be employed by a payer. I always learn something that a doctor ought to know from her real world examples...
by Caroline Fife, M.D. | Aug 23, 2021 | Healthcare Payment Policy
The Center for Medicare and Medicaid Services (CMS) moves slowly but once they start down a path, they don’t stop (no matter who is the President). In 2008 they started down a path to link Physician payment to patient outcome. It doesn’t seem real yet. If you do...
