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6 / 21 / 2023

Medicare’s Change to the Split/Shared Billing Rules: Implications for Physician Compensation Planning

By
Jodi Nayoski
1.  What is a split/shared service? This term refers to evaluation and management services that are performed partly by a physician and partly by a non-physician practitioner (NPP) who...
6 / 14 / 2023

As CMS Focuses on Quality, there are Monumental Changes to Reimbursement for Quality on the Horizon!

By
Amy Crenshaw-Pritchett
The Centers for Medicare and Medicaid Services (“CMS”) utilize risk adjustment factors to estimate the cost of Medicare Advantage (“MA”) beneficiaries and those associated costs of providing care.  Risk...
5 / 3 / 2023

Non-Compete Contracting in Healthcare: Potential Impact on Physician Contracting and Alignment

By
David White
Introduction A covenant not to compete (a.k.a. a non-compete agreement) is a contract or clause in a contract specifying that an employee or contractor (often through a professional services...
3 / 14 / 2023

Tele-Nephrology – The Future is Now

By
David White
In recent years, the healthcare industry has seen a surge in the use of telehealth services, and nephrology is no exception. Remote nephrology, or tele-nephrology, involves the use of...
2 / 22 / 2023

PHC 3rd Quarter 2022 Real Estate Newsletter

By
Mike Vandaveer
The Pinnacle Real Estate Group consists of a combination of professionals who use their extensive experience in both valuation and transaction services within the healthcare real estate industry to...
2 / 21 / 2023

CMS Changes ACO Application Cycle! Are You Ready?

By
Kelly Conroy &
Zach Maher &
Daniela Yusufbekova
The Centers for Medicare and Medicaid Services finalized changes to the 2023 ACO application cycle steps and timelines. After collectively submitting 50+ successful applications, Pinnacle is excited to continue...
2 / 16 / 2023

New ACO/VBC Changes Announced: What You Need to Know!

By
Kelly Conroy &
Zach Maher &
Daniela Yusufbekova
Our healthcare industry is undergoing a major transformation, with a focus on shifting from a fee-for-service model to a value-based model that prioritizes quality and outcomes over volume and cost....
1 / 26 / 2023

Sepsis Coding: How to Properly Code Sepsis

Introduction: Sepsis is a potentially life-threatening complication of an infection and occurs when chemicals released in the bloodstream to fight the infection trigger inflammatory responses throughout the body. This inflammation...
1 / 16 / 2023

Clinical Documentation Improvement: Are EMR Shortcuts Wreaking Havoc on Your Practice’s Documentation?

By
Angela Wood
As providers look for ways to document more efficiently, they are increasingly turning to technology-based shortcuts. Unfortunately, there are some pitfalls associated with relying on some electronic medical record (EMR)...
11 / 11 / 2022

Diagnosis Coding: When to Assign a Diagnosis for E/M Services

With the implementation of the AMA (American Medical Association) E/M (Evaluation and Management) documentation guidelines for office and outpatient visits in 2021 (and the pending 2023 E/M guideline changes for...