5 / 3 / 2023
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...
6 / 21 / 2023
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...
1 / 26 / 2023
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
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)...
6 / 14 / 2023
As CMS Focuses on Quality, there are Monumental Changes to Reimbursement for Quality on the Horizon!
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...
6 / 26 / 2023
Modifier 25 Scenarios Is your documentation up to par to support Modifier 25? First, you should read The Center for Medicare and Medicaid Services (CMS) National Correct Coding Initiative...
8 / 1 / 2023
In a time where healthcare costs continue to rise, there is a diverse range of payment models in use, ranging from traditional fee-for-service to global capitated payment, to stunt...
8 / 3 / 2023
Pinnacle has reviewed the proposed rule changes for CY2024 related to the Medicare Physician Fee schedule. CMS has also published a fifteen (15) fact-sheet summary. The condensed overview below...
8 / 3 / 2023
While mental health awareness month occurred in May, we need not forget the upcoming changes to Medicare Advantage members in CY 2024 and beyond. On March 31, 2023, The...
8 / 8 / 2023
COVID-19 public health emergency (PHE) ended on May 11, 2023. Medicare’s coverage of telehealth for outpatient services will be extended through the end of 2024. Patients may continue to...