Late last year, CMS updated and issued a pair of educational resources that address Medicare coverage of chiropractic services. The Medicare Learning Network booklet on chiropractic services (pdf) outlines the standards chiropractors must meet to render payable services under the program; common care provision scenarios (including exceptions) and actions that Medicare would take as a […]
Louri Roberts
CPC, CCS-P
Director of Client Services
20+ years of experience
Louri Roberts serves as the director of client services for Physicians Group Management. She has more than 20 years of experience in healthcare in areas including payer relations, revenue cycle management, operational consulting, laboratory development, and inspection and management. Prior to joining PGM, Louri served as the co-founder and chief operating officer of Peachtree Medical Billing, a leading provider of laboratory billing services throughout the United States. She received her BS in microbiology from the University of Georgia.
Posts by Louri Roberts
Medicare Increases Scrutiny of Billing E/M Services With Allergy Testing or Allergy Immunotherapy
Medicare is paying closer attention to organizations that bill evaluation and management codes reported with allergy testing or allergy immunotherapy. This is according to a recent issue of Medicare Quarterly Provider Compliance Newsletter (pdf), a newsletter from CMS developed to help providers understand the major findings identified by Medicare administrative contractors, recovery auditors and other […]
Billing Tip: Ensure Visits Billed as ‘Incident To’ Meet Medicare Criteria
The U.S. Department of Health and Human Services (HHS) is more closely scrutinizing services billed at physician reimbursement levels but performed by nonphysicians, according to a Medical Economics report HHS indicated its intention to take a closer look at these “incident-to” services, which are often performed by nurse practitioners and physician assistants, in its Office […]
Data Disaster Preparedness
Nov 5, 2010 – As physician practices have embraced moving toward EMR (electronic medical record), a lot of resources have and will be spent on choosing the best system to meet the practice needs and to qualify for the Federal Stimulus dollars for meaningful use EHR (electronic health record) implementation. Do you have a plan, process […]
Medical Billing – Physicians Options
Mar 28, 2011 – It’s no secret that the healthcare is inundated with paperwork. Many medical professionals claim they spend more time filling out forms than actually treating patients. A large portion of the endless pile of paperwork is related to coding, submitting and processing medical claims related to physician or medical billing. With no […]
Selecting the Right Medical Billing Service – A Process Cheat Sheet
Apr 11, 2011 – Choosing the right Medical Billing Company from all the Medical Billing providers available is one of the most crucial business decisions a physician, practice manager or facility administrator must make. In practice, with over 7,000 Medical Billing Companies in the US, the decision making process can be rather difficult. Therefore a […]
The Importance of Payor Mix and Fee Schedule Examination
Apr 25, 2011 – Preventive medicine is an important part of good healthcare. The old saying of an ounce of prevention is worth a pound of cure really does contain truth. Not only should patients be encouraged to follow a good preventive health schedule but it is also important for the practice to follow some […]
Medicare Improvements in 2011
May 2, 2011 – Medicare reform continues to be at the forefront of the political debate as efforts to lower the overall cost of healthcare and provide a high level of care remain at issue. Several key changes to Medicare in 2011 are as follows: Shrinking donut hole. In 2010 a Medicare beneficiary could receive […]
Medical Billing: The Benefits of Outsourcing
May 9, 2011 – According to numerous surveys, doctors and hospital executives claim that payment collection for services rendered is quickly becoming one of the most important issues they face today. An overly complex system of rules, regulations and participants has forced many medical practitioners to invest considerable time and resources to payment collection. Managing the […]
Medicare Fraud: Abuse of the System & Means of Struggle
May 16, 2011 – There are many different kinds of Medicare fraud yet the goal is always the same – to rook money from the Medicare program. Generally Medicare fraud is challenging to track as not all fraud is detected and not all suspicious claims prove to be fraudulent. That is when Medicare abuse is […]