In Audit
Nov 22nd, 2017
The Office of Inspector General (OIG) is recommending Rush University Medical Center, Chicago, Ill., refund $10.2 million in Medicare overpayments based on an audit sample of 120 inpatient and outpatient claims. Rush allegedly did not fully comply with Medicare billing requirements for 57 of the claims, resulting in overpayments of $814,150 for the audit period (2014-2015). The OIG ...
In Audit
Oct 16th, 2017
You billed the insurance company for a service provided by your office only to receive a denial remittance. Is the denial valid? Why wasn’t the claim paid? Who can review the explanation of benefits summary and make a determination? Enter the appeals analyst — an essential position for physician offices, hospitals and clinics, as well ...
In Audit
Aug 30th, 2017
One week after the release of the 2018 ICD-10-CM Official Guidelines by the Centers for Disease Control and Prevention (CDC), the agency released an errata with updated rules for diabetes mellitus, hypertension, and principal diagnosis. And while some publishers, like AAPC, were able to put their ICD-10-CMs to press with the new guidelines, it was too ...
In Audit
Aug 28th, 2017
“A Brooklyn Chiropractor Received Unallowable Medicare Payments for Chiropractice Services,” declares the Office of Inspector General (OIG) in an August 2017 report. According to the report, the New York chiropractor received at least $672,000 in improper payments over a two-year period. There’s a lesson to be learned here for chiropractic coders. First, Some Background Chiropractic ...
In Audit
Aug 15th, 2017
Effective June 15, 2017, the Office of Inspector General (OIG) now updates its Work Plan website, monthly. The OIG Work Plan sets forth various projects — including OIG audits and evaluations that are underway or planned — to be addressed during the fiscal year and beyond by OIG’s Office of Audit Services and Office of ...