Aug 1st, 2013
Become familiar with it, make a plan, and it will keep your claims and business clean.  By Evan M. Gwilliam, DC, CPC, CPC-I, CCPC, CPMA, NCICS, CCCPC, MCS-P In October 2000, the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) published in the Federal Register general guidelines for healthcare facilities ...
Mar 1st, 2013
By Ida Landry, MBA, CPC Knowing coding and billing rules, and following them with integrity, is key to success. Compliance is an important part of medical coding. Novice coders are instructed early on that “correct coding is the No. 1 objective,” and “if it isn’t documented, it wasn’t done.” These rules of thumb are the ...
In Audit
Nov 15th, 2012
If you receive a letter from a Medicare recovery audit contractor (RAC) regarding overpayment, don’t panic! You may think you only have two options: pay up or launch an appeal. There is another option, however, if you move fast (before a formal appeals process starts) and are certain the RAC is mistaken about the overpayments. ...
In Audit
Dec 30th, 2011
Influenced by the opinion of the American Hospital Association (AHA) and state and regional hospital associations, CMS recently announced that it is revising its alleged overpayments demand letter sent to health care providers under the Medicare Recovery Audit Contractor (RAC) program. CMS Hears Call for RAC Demand Letter Improvement was last modified: January 2nd, 2012 by admin ...
Aug 1st, 2010
Coding crossroads to health care’s future leave auditors in high demand. By Deborah Grider, CPC, CPC-H, CPC-I, CPC-P, CPMA, CEMC, COBGC, CPCD, CCS-P Well over 20 years ago documentation was generated by the provider only as an information source for patient care. The information was housed in the patient’s chart and kept in a file ...