by Caroline Fife, M.D. | Feb 27, 2023 | Healthcare Payment Policy
A few days ago, I got one of those CMS “eblasts” about the results of Medicare CERT audits (Comprehensive Error Rate Testing). The audit looks at whether there is sufficient documentation to back up the claim against Medicare. In 2021, CMS estimated that, based on...
by Caroline Fife, M.D. | Feb 13, 2023 | COVID-19, Healthcare Payment Policy
I got an email from a fantastic wound clinic manager who is worried about the less than stellar documentation she’s noted on the part of her advanced practitioners. She’s trying to raise the bar on wound care documentation and asked me how best to do that. That’s a...
by Caroline Fife, M.D. | Feb 2, 2023 | Healthcare Payment Policy, Quality Payment Program
I suspect that most of the people reading this have at some point in their lives, quietly accomplished something that they know to be important but which will largely go unnoticed. Sometimes we do things just because we have to be at peace with the person who looks...
by Caroline Fife, M.D. | Dec 2, 2022 | Healthcare Payment Policy
Check out this article by Marcia Nusgart in Today’s Wound Clinic: 2023 Medicare Physician Fee Schedule: Wound Care Wins, Challenges, and Opportunities! Caroline Fife, M.D.Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes...
by Caroline Fife, M.D. | Nov 4, 2022 | Cellular / Tissue-Based Products, Healthcare Payment Policy
The Centers for Medicare and Medicaid Services (CMS) has issued the final rule for the 2023 Physician Fee schedule CMS IS NOT finalizing the payment approach outlined in the proposed rule in which they proposed to make Cellular and/or tissue-based products (CPTs) part...
by Caroline Fife, M.D. | Nov 1, 2022 | Healthcare Payment Policy
I just finished a FREE 4 part series with Kathleen Schaum about keeping money after an audit. Here are the top 10 things that Kathleen Schaum listed as the reasons doctors and hospitals lose money when audited (my paraphrase of what she said): Lack of documentation to...
by Caroline Fife, M.D. | Oct 12, 2022 | Healthcare Payment Policy
There’s an astounding increase in every possible type of Medicare audit – one of which is the Recovery Audit Contractor (RAC) audit. It’s a good idea to keep abreast of all the resources available. Check out RACmonitor and its monthly podcast. The site is an online...
by Caroline Fife, M.D. | Sep 20, 2022 | Fight the Good Fight, Healthcare Payment Policy
I am a huge fan of Knicole Emanuel’s Medicare & Medicaid legal blog. Check out her most recent post about whether auditors can “double dip” by overlapping concurrent audits. EVERYONE is being audited. In fact, if you don’t think you have been audited, it’s likely...
by Caroline Fife, M.D. | Sep 19, 2022 | Healthcare Payment Policy
SESSION 1: Keeping Payments After An Audit Wednesday, Sept. 28 at 5 pm EST Join Kathleen Schaum and me, as we explore the trends and threats of audits hitting wound care practitioners across America. Attendees are invited to ask questions and provide their...
by Caroline Fife, M.D. | Sep 14, 2022 | Cellular / Tissue-Based Products, Healthcare Payment Policy
Check out the newest article about CMS NEWS in Today’s Wound Clinic – “Could Proposed Policy Changes in the 2023 Physician Fee Schedule Increase Amputations and Infections in Patients With Wounds?” by Marcia Nusgart, RPh. The Alliance of Wound Care Stakeholders is...