Medicare and Maine Medicaid Healthcare Fraud Settlement Case

  • Steve Nesnidal, MD, CPC, AHFI
  • May 17, 2023
  • Comments
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A Maine family practitioner used false claims billed to Medicare and Medicaid for services that were either not provided or not medically necessary, which provides reasons for the need of Fraud, Waste, and Abuse (FWA) protection.

Dental Fraud in Medicaid

  • Steve Nesnidal, MD, CPC, AHFI
  • May 09, 2023
  • Comments

A multi-million dollar dental fraud scheme provides an example to the benefits of having fraud, waste, and abuse (FWA) protection. Click to learn more.

Why Fraud Analytics Are Important to You

  • John Danza
  • Oct 17, 2022
  • Comments
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A multi-million dollar scheme serves as a prime example to the benefits of Fraud, Waste, and Abuse (FWA) protection. The story of a doctor performing an alarmingly high amount of surgeries not typically conducted by their specialty is awakening to the need for robust safeguarding solutions.

Evaluation and Management with Psychotherapy

  • Steve Nesnidal, MD, CPC, AHFI
  • Sep 26, 2022
  • Comments

CPT provides distinct codes for reporting face-to-face Psychotherapy with two different approaches. Either an Evaluation and Management (E/M) code can be submitted in tandem with a Psychotherapy add-on code, or a standalone Psychotherapy code can be submitted. Press "Read More" to learn how to use these codes appropriately.

CMS Adds and Updates Place of Service Telemedicine Codes

  • Steve Nesnidal, MD, CPC, AHFI
  • Feb 11, 2022
  • Comments

On January 1, 2022, CMS’s Place of Service (POS) Workgroup added new POS code 10, with description "Telehealth Provided in Patient’s Home". Simultaneously, the established POS code 02 description was changed to "Telehealth Provided Other than in Patient’s Home".

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