Blog

Find news and solutions for healthcare payers and providers. Recognize and avoid potential fraud, waste, and abuse scenarios. Real-time clinical claim editing are analyzed to maximize provider reimbursements.

Fighting Fraud in Medical Nutrition Therapy

  • Steve Nesnidal, MD, CPC, AHFI
  • Apr 27, 2021
  • Comments
Nutrition

The role of nutrition in chronic disease management is especially crucial, as it is a modifiable risk factor for many conditions such as chronic renal failure (CRF), diabetes mellitus (DM), obesity and coronary artery disease (CAD). Payers who bear significant long-term healthcare utilization burdens due to obesity and cardiovascular risk factors may determine that Medical Nutrition Therapy (MNT) preventive coverage is a cost-effective policy approach for their beneficiaries.

Impact of the COVID-19 Pandemic on Healthcare Fraud

  • Steve Nesnidal, MD, CPC, AHFI
  • Apr 07, 2021
  • Comments
Stop Fraud Image - Large

During the pandemic, healthcare claim fraud prevails as new fraud schemes develop and adapt to the changes in healthcare guidelines enacted, so providers can continue to treat patients. Two major areas of FWA expansion during the pandemic include Telehealth and COVID-19-related laboratory testing add-on services.

Janssen Single-Dose COVID-19 Vaccine is Pending FDA Emergency Use Authorization

  • Steve Nesnidal, MD, CPC, AHFI
  • Feb 23, 2021
  • Comments
iStock-vaccineresearch_smaller

UPDATED AS OF 6/9/2021. Janssen Biotech, Inc. applied to the FDA for Emergency Use Authorization (EUA) of its single-dose COVID-19 vaccine, which may be a highly desirable weapon used to fight the virus based on characteristics and efficacy data.

Effective dates now known for Pfizer and Moderna vaccines, AstraZeneca vaccine coming

  • Steve Nesnidal, MD, CPC, AHFI
  • Dec 24, 2020
  • Comments
COVID Vaccine

Pfizer and Moderna Covid vaccine codes receive effective dates, AstraZeneca vaccine assigned procedure codes but not yet effective.

New COVID-19 Vaccine Codes Released, Effective Pending FDA Approval

  • Steve Nesnidal, MD, CPC, AHFI
  • Nov 17, 2020
  • Comments
COVID Vaccine

AMA has released a series of new, unique CPT Category I codes for use in reporting COVID-19 FDA approved vaccines. The codes will become active as soon as the FDA approves the first two COVID-19 vaccines produced by Pfizer and Moderna.

Subscribe to Our Blog:

Connect With Us

Authors


Proudly Affiliated with:

Proud_Members_Logo_250X100   National Association of Dental Plans Member   FedRAMP  Amazon Web Services