Essential Data Elements for Payer Credentialing

Credentialing and enrollment are critical processes that impact many facets of the healthcare industry. When not managed properly they can negatively impact a healthcare organization’s revenue. With regulatory requirements becoming more and more complex, incorrectly and poorly managed credentialing and enrollment processes also put hospitals at risk of compliance violations.NAMSS (National Organization Medical Staff Services) […]

Coding Unbundled

Coordinated Health in Pennsylvania, founded by its CEO, Dr. DiIorio, was on track to compliant coding when they hired outside consultants to audit their coding practices. The consultants found that the facility and Dr. DiIorio, a board-certified orthopedic surgeon, were misusing Modifier 59 (Distinct Procedural Service) in order to unbundle services from 2007 through 2014. […]