Context to Make a Splash as Exhibitor at SIIA Conference - Phoenix, AZ

  • Kate Armbruster
  • Oct 02, 2014
  • Comments

Context 4 Healthcare will showcase its payer solutions as an exhibitor at the SIIA 34th Annual National Educational Conference & Expo taking place October 5 - 8, 2014 at the JW Marriott Desert Ridge Resort & Spa in Phoenix, AZ. The SIIA National Conference & Expo is the world’s largest event focused exclusively on the self-insurance/alternative risk transfer marketplace, typically attracting more than 1,700 attendees from throughout the United States and from a growing numbe ...

Are Your Clinical Lab Drug Screenings Free From Fraud?

  • Cindy Gallee, JD, RHIA, CHC
  • Sep 26, 2014
  • Comments

Recently, a fraud scheme was uncovered in Virginia involving a substance abuse clinic and the prescription of Suboxone with accompanying laboratory billing of urine drug screens. The substance abuse clinic prescribed its patients weekly Suboxone, a treatment for opioid addiction, for which a urine drug screen was required at each visit. While the clinic did not accept insurance, the drug screens were provided by a laboratory owned by the same owners as the clinic, which billed insurance up to ...

Avoid Overpayment - Review Documentation for Outpatient Therapy Claims

  • Cindy Gallee, JD, RHIA, CHC
  • Sep 11, 2014
  • Comments

Outpatient physical therapy claims present an area that has long been fraught with the potential for billing fraud, waste and abuse. The Office of Inspector General (OIG) has issued several reports in past years concerning outpatient physical therapy claims that were not reasonable, not medically necessary and / or not properly documented. Most recently, the OIG has reviewed several high billers of physical therapy according to Medicare and determined one such high biller had a 99% error rate i ...

The “X” Factor: 4 New Modifiers Will Define the Use of - 59 in 2015

  • Margaret Klasa DC, APN BC
  • Sep 11, 2014
  • Comments

On August 15, 2014, the Centers for Medicare & Medicaid Services (CMS) introduced four new Healthcare Common Procedure Coding System (HCPCS) modifiers that will clarify the use of modifier -59. The modifier -59 description implies that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. Provider specialties and others often use it to override edits found in Medicare’s National Correct Coding Initiativ ...

Context is Headed to the Plexis 2014 Users Conference in Ashland, OR

  • Kate Armbruster
  • Sep 08, 2014
  • Comments

Context 4 Healthcare will showcase its FirstPass™ claim editing solution as an Integrated Partner exhibitor at the Plexis 2014 Users Conference taking place September 14 - 18 in Ashland, OR. Context’s FirstPass™ claim editing solution is integrated with the Plexis claim management system and provides users with direct access to edit results via a real time web services interface. The  FirstPass™ professional and institutional edits are updated weekly and are autom ...

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