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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!
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...
DME schemes-intermittent catheters, but what’s next?
Everyone in the healthcare field is very aware of the ongoing DME billing schemes. The most recent topic in the news has been the intermittent catheters schemes. Catheters are thin, flexible tubes that play a crucial role in managing various urinary and other medical...
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
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, 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
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...
Time is Money: Automating Your Case Prioritization Process
Who has enough time in their day to do everything you need to do? Almost no one. If you are going to the NHCAA Annual Training Conference in Dallas, then you don't want to miss this session. If you aren't able to attend, let us know and we can provide you free...
Transfixed by the SI Joint
There has been a seismic change to the coding and reimbursement for sacroiliac (SI) joint procedures over the last few years – we’re “transfixed” on this hot topic. New and disruptive minimally invasive procedures and techniques have come onto the market since 2018-...
Learning About Lancets
For those afflicted with diabetes, managing all the different devices and the disease may feel like a daunting task. Even more intimidating may be learning what devices are covered and how much is covered. There are many different ways to treat and monitor diabetes....
What You Should Know About LEQEMBI
LEQEMBI is a newly approved drug by the U.S. Food and Drug Administration (FDA) for the treatment of Alzheimer’s disease. According to the FDA, “Alzheimer’s disease is an irreversible, progressive brain disorder affecting more than 6.5 million Americans that slowly...