by Terry Fletcher
Taking the Business of Medicine to the next level
Language
🇺🇲
Publishing Since
3/21/2023
Email Addresses
1 available
Phone Numbers
0 available
April 22, 2025
We all know the age-old question, “Where does it say that?” In this episode, Terry brings receipts, explaining it’s been this way since 2003:<br /> “Reviewing results of laboratory tests, phoning results to patients, filing such results, etc., are Medicare-covered services. Payment is included in the physician fee schedule payment for the evaluation and management (E/M) services to the patient. The CPT lists different levels of E and M services for both new and established patients and describes services that are included as E/M services. Such activities include obtaining, reviewing, and analyzing appropriate diagnostic tests.”<br /> Tune in to this episode for an in-depth discussion as Terry details trying to report a telehealth visit for giving test results may be considered double-dipping: and can get you into hot water!<br /> Subscribe and Listen<br /> You can subscribe to our podcasts via:<br /> <br /> * Apple Podcasts – <a href="https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627" target="_blank" rel="noopener noreferrer">https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627</a><br /> * Spotify – <a href="https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX" target="_blank" rel="noopener noreferrer">https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX</a><br /> * TuneIn – <a href="https://tunein.com/radio/CodeCast--Medical-Billing-p1056702/" target="_blank" rel="noopener noreferrer">https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/</a><br /> * YouTube – <a href="https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg" target="_blank" rel="noopener noreferrer">https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg</a><br /> * YouTube Music – <a href="https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ" target="_blank" rel="noopener">https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ</a><br /> * Pandora – <a href="https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874" target="_blank" rel="noopener">https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874</a><br /> * Amazon Podcasts – <a href="https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights" target="_blank" rel="noopener">https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights</a><br /> * iHeart Radio – <a href="https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/" target="_blank" rel="noopener">https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/</a><br /> <br /> If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: <a href="https://www.terryfletcher.net/contact/">https://www.terryfletcher.net/contact/</a><br />
April 15, 2025
An ADR (Additional Documentation Request) is a request from CMS or another insurance payer for additional documentation to review a claim. Most of these requests come from payer investigative units looking for medical necessity support.<br /> Terry discusses how to handle these requests, as well as how to ensure they are addressed promptly to meet the deadlines typically associated with them.<br /> Subscribe and Listen<br /> You can subscribe to our podcasts via:<br /> <br /> * Apple Podcasts – <a href="https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627" target="_blank" rel="noopener noreferrer">https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627</a><br /> * Spotify – <a href="https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX" target="_blank" rel="noopener noreferrer">https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX</a><br /> * TuneIn – <a href="https://tunein.com/radio/CodeCast--Medical-Billing-p1056702/" target="_blank" rel="noopener noreferrer">https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/</a><br /> * YouTube – <a href="https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg" target="_blank" rel="noopener noreferrer">https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg</a><br /> * YouTube Music – <a href="https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ" target="_blank" rel="noopener">https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ</a><br /> * Pandora – <a href="https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874" target="_blank" rel="noopener">https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874</a><br /> * Amazon Podcasts – <a href="https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights" target="_blank" rel="noopener">https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights</a><br /> * iHeart Radio – <a href="https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/" target="_blank" rel="noopener">https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/</a><br /> <br /> If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: <a href="https://www.terryfletcher.net/contact/">https://www.terryfletcher.net/contact/</a><br />
April 8, 2025
If the provider discusses their preferred management options with the patient, do they receive the “risk” credit even if the patient declines it? If yes, how long do they get to capture it?<br /> Terry breaks down, citing references, how to handle this MR element and ensure the providers are receiving the correct “risk” value for their encounter. Listen to this episode for all of the details.<br /> Subscribe and Listen<br /> You can subscribe to our podcasts via:<br /> <br /> * Apple Podcasts – <a href="https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627" target="_blank" rel="noopener noreferrer">https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627</a><br /> * Spotify – <a href="https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX" target="_blank" rel="noopener noreferrer">https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX</a><br /> * TuneIn – <a href="https://tunein.com/radio/CodeCast--Medical-Billing-p1056702/" target="_blank" rel="noopener noreferrer">https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/</a><br /> * YouTube – <a href="https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg" target="_blank" rel="noopener noreferrer">https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg</a><br /> * YouTube Music – <a href="https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ" target="_blank" rel="noopener">https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ</a><br /> * Pandora – <a href="https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874" target="_blank" rel="noopener">https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874</a><br /> * Amazon Podcasts – <a href="https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights" target="_blank" rel="noopener">https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights</a><br /> * iHeart Radio – <a href="https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/" target="_blank" rel="noopener">https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/</a><br /> <br /> If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: <a href="https://www.terryfletcher.net/contact/">https://www.terryfletcher.net/contact/</a><br />
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