Betsy Nicoletti

Medical Coding and Compliance Expert, Speaker, Educator, and Auditor

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Care Management Services

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Physicians are frustrated when they do work, not related to seeing a patient, and don’t get paid for it. And yet, it is vitally important to their patients and families.

This webinar will describe three sets of care management services that can be billed by primary care practitioners and specialists. Transitional care management (TCM) is for managing the transition of complex patients from a facility to a non-facility (typically, home). Principal care management (PCM) services, currently described with HCPCS codes, were developed for specialists managing one serious condition. And chronic care management (CCM), describes work that can be performed by clinical staff or practitioners for patients with two or more chronic illnesses. This webinar will describe the rules and reimbursement for TCM, PCM and CCM.

After the webinar, participants will be able to:

  • Select the correct care management service
  • Describe the time requirements for services their practice can perform, and whether the service must be done by the billing practitioner or clinical staff
  • Review the documentation for the service

Filed Under: Uncategorized

Preventive medicine and Medicare wellness visits with an E/M

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While both CPT allows medical practices to bill for both a preventive service and an E/M. CMS allows practices to bill for both a wellness visit and an E/M.  When to do it, and how to document the distinct and separate work of the E/M service, isn’t very clear. This webinar will provide an overview of what is included in preventive services and Medicare wellness visits, and when a problem-oriented visit can be reported in addition. It will provide a framework for practices when determining when there is significant extra work performed and documented, supporting the addition of a problem-oriented visit.

After the webinar, participants will be able to:

  • List what is included in preventive and wellness visits
  • Implement a framework to determine if a separate E/M service should be reported
  • Suggest communication messages to patients within their practices

Filed Under: Uncategorized

Telemedicine in the time of COVID-19

March 23rd, 2020

The coding and reimbursement rules for telehealth changed fast in March. Congress passed a law relaxing certain telemedicine restrictions during the period of a government state of emergency. CMS released rules ten days later with instructions on billing for telehealth, and reminding practices of other non-face-to-face services that can be reported. Some private payers are following suit. This webinar will describe the new telehealth Medicare rules. Join us to learn about CPT coding for telehealth, diagnosis coding, and the type of communication that can be used for telehealth services.

After the webinar, participants will be able to:

  • Find the CPT and HCPCS codes that may be reported via telehealth
  • Describe the updated CMS Medicare rules
  • Select accurate diagnosis codes for COVID-19

Filed Under: Uncategorized

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“My organization approached Betsy Nicoletti because we had providers failing coding audits.

Betsy’s name is out there in the coding world as a leader in the field and wanted the best for our providers.

Betsy works with the organization to set up webinars for our new provider on boarding training process (which according to them has been most beneficial), as well as subsequent auditing to ensure provider engagement and understanding.

Betsy’s one on one approach has helped the organization overall by the specialized attention to our specific needs.

I appreciate Betsy’s tactful approach with the providers to lessen their concerns as it relates to proper coding. She is up to date on all of the current changes in coding and maintains the communication whenever warranted.

Overall I have found the experience of working with Betsy as positive and educational. I would not hesitate to recommend Betsy to any organization that needs to improve their coding practices and improve success rates from outside auditing.”

Julie D., LPN
Clinical Performance/Operations Manager

• Develop agenda with Betsy*
• Betsy will customize presentation and prepare learning materials
• 90 minute Zoom, live education session
• 30 days Q&A follow up
• Recording of session to show new hires
• Interactive: everyone hears the same thing and can ask questions

*Betsy’s area of expertise doesn’t include all procedural coding – email to set up a time to discuss your needs