May 22nd, 2019
How to Survive a Personal Audit Almost no one enjoys being audited, but it is an important part of our professional lives and can make us better coders. It is often difficult for coders to strive to balance quality and productivity, and to be successful at both. And yet, both of these are very important ...
Dodging them means your practice will better serve patients, decrease risks, and improve cash flow. In today’s environment of increasing regulatory oversight and ever-changing reimbursement policies, compliance requires concerted effort and plan. Although healthcare organizations are not federally mandated to implement a compliance and auditing program, it’s foolish not to. Done right, a complianc...
In Audit
Apr 12th, 2019
Recovery Auditors have been busy. This year alone there are 23 topics under review and three more were just proposed. If you are coding/billing for any of the topics under review, this may be all the reason you need to conduct an internal review. Who Are They? Recovery Auditors, or Recover Audit Contractors (RACs), review ...
In Audit
Mar 6th, 2019
If  you receive Additional Documentation Requests (ADR) from a Medicare Administrative Contractors (MAC) and others, here are some tips  to respond most effectively. Additional Documentation Request Success Isn’t that Hard CGS  Administrators, a MAC and Durable Medicare Administrative Contractor (DMAC) with a presence in 38 states, offers helpful tips in their ADR process.  ADRs may ...
In Audit
Mar 4th, 2019
Follow this step-by-step guide to coding and documentation compliance. It’s always better for a facility to find compliance issues before a government agency or payer does (who may respond by levying penalties and fines). Pre- or post-bill audits help facilities uncover minor concerns before they become major compliance issues, thereby promoting revenue integrity. Here’s how ...