Exclusive: ACR Convergence 2024| Focus Rheums

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Billing/Coding

Clean Claims Equal Prompt Payment

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Submitting a clean Medicare reimbursement claim the first time can save your practice thousands of dollars each year. The Centers for Medicare and Medicaid Services (CMS) defines a clean claim as “a submitted patient claim form without any defect or need for substantiation.”

Fraud and Abuse: What’s the Difference?

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Each year, fraud and abuse cost the Medicare and Medicaid programs billions of dollars. What is the difference between fraud and abuse? The Centers for Medicare & Medicaid Services define fraud and abuse as two different offenses…

Consultation or Referral? That Is the Question

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One of the most troublesome coding decisions is determining whether a visit is a consultation or a referral. To avoid the hassle of incorrect coding, one must first understand the difference between a consultation and a referral.