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HCFS employees highly respected industry known Subject Matter Experts are sought after to speak regularly for not only our clients, but a myriad of industry organizations. Our team is dedicated to not only FWA detection and prevention, but to education. We provide complimentary scheme oriented articles used by both clients and non-clients providing actionable takeaways and insights that have led to millions of dollars of savings and recoveries. Sign up for our newsletter!

New Codes, BIG Smiles!

New Codes, BIG Smiles!

The American Dental Association (ADA) implemented a revised set of Current Dental Terminology (CDT) codes for 2024 [1], to reflect advancements in dental procedures and materials. These codes became effective on January 1st and consist of fourteen new codes, one new...

DRG Deception? How DRG Abuse Inflates Sepsis Claims

DRG Deception? How DRG Abuse Inflates Sepsis Claims

Understanding Diagnosis Related Group billing (DRG) is crucial for ensuring fair and accurate payments for the care insurance companies provide coverage for. Let us break down what it means and how it affects hospital reimbursements. What is DRG Billing and How Does...

Decoding Annual Wellness Visits (AWV)

Decoding Annual Wellness Visits (AWV)

Medicare lays out clear guidelines for Annual Wellness Visits (AWV), including Personalized Prevention Plan Services (PPPS). There are a number of specific requirements of these visits in order to be eligible for reimbursement. Providers will develop a personalized...

Small Patients, Big Challenges: Using Modifier 63

Small Patients, Big Challenges: Using Modifier 63

This article delves into modifier 63, a key piece for dealing with the smallest patients, infants weighing less than 4 kg. Modifier 63 addresses the additional time, complexities, and challenges of treating infants under 4kg or about 8.8 pounds. To put this in...

Nuedexta: Laughter, Tears, & Off-Label Use

Nuedexta: Laughter, Tears, & Off-Label Use

Nuedexta, a drug marketed for Pseudobulbar Affect (PBA), a condition causing uncontrollable laughing or crying, finds itself under a cloud of controversy. According to the manufacturer[1]: “PBA is a medical condition that causes involuntary, sudden, and frequent...

Off-Label Use Of Adderall

Off-Label Use Of Adderall

  In this article, we discuss Adderall and its treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) as well concerns expressed by Federal agencies regarding Adderall drug shortages including a range of factors leading to such shortages such as off-label...