Jennifer McNamara

In 2021, when the Evaluation and Management guidelines were revised, the area with the most confusion was ultimately the amount and/or complexity of data to be reviewed and/or analyzed. Like with other components, misunderstandings with definitions and descriptions were at the root of the problem.

In September 2022, the American Medical Association released the revised E/M guidelines for 2023, bringing the 2021 Guidelines in alignment with other code sets for Evaluation and Management Services. This is part of their ongoing effort to reduce physician documentation burdens.

In October we raise awareness for Breast Cancer since it is the second most common cancer that women in the United States face according to the CDC. Every year in the United States, we see cases of about 264,000 in women and 2,400 in men. The mortality rate for women is higher at 42,000 and 500 for men just in the U.S. alone. It is vital that we raise awareness for prevention, early detection, and access to treatment.

Are you struggling with your Evaluation and Management reimbursement for Radiation Oncology services? Radiation Oncology has nuances, and you may be leaving money on the table without a good understanding of how the 2021 Evaluation and Management guidelines impact Oncology services.

In today’s business of healthcare landscape making mistakes can cost a Medical Practice or facility thousands annually. Do you know the true cost of the errors made in claim submission at your facility or clinic? Understanding the errors is part of the equation but the most beneficial thing we can do is learn to prevent these errors in the first place. We must develop a proactive approach to our data and use it to our benefit.

I have experience with nearly all operational roles in a provider’s practice. I have been involved in almost every role in the medical office except for clinical. This has provided me with a unique understanding of the barriers and opportunities for patients and providers for the healthcare process.

In my 20 years in healthcare, I have seen numerous changes in financial and operational processes. None has been more disruptive than the increase in the requirement for prior authorization.