Eli's Hospice Insider
Data Mining To Drive Investigations
PDF
If your billing patterns make you stick out like a sore thumb, you may see pre-payment consequences sooner than you think.
The Centers for Medicare & Medicaid Services is aiming to integrate its new data-driven Fraud Prevention System with its payment processing system by January, says the Government Accountability Office in a new report. "FPS analyzes Medicare claims data using models of fraudulent behavior, which results in automatic alerts on specific claims and providers, which are then prioritized for program integrity analysts to review and investigate as appropriate," GAO explains.
However: CMS has "not yet developed reliable schedules for completing this activity," the GAO says of the FPS-payment system integration. The report is at www.gao.gov/products/GAO-13-104.
Eli's Hospice Insider
- Compliance:
OIG OKs Free Program Offering Non-Skilled Services
3 factors keep proposed arrangement in the clear. The OIG has put its stamp of [...] - Kickbacks:
Beware Pitfalls In Furnishing Bridge Services
Follow these 5 steps to compliance. If you want to protect your free [...] - Reimbursement:
Keep '42' Codes Straight, CMS Tells Providers
Also: You’re still responsible for your quality data submission, not your vendor. Even if you [...] - Diagnosis Coding:
Take These 6 Steps To ICD-10 Transition Success
A working budget should encompass every aspect of planning, including productivity training. With [...] - Hospice News:
Hospice Settles Qui Tam Suit for $1.3 Million
Hospice owner personally liable for $200K. More evidence that the feds are cracking down on [...] - Hospice News:
OIG Highlights Marketing, GIP Fraud
The HHS Office of Inspector General’s latest semiannual report is playing the agency’s greatest hits [...] - Hospice News:
Keep Your Quality Data Reporting Duties Straight In New Year
January will be a busy month for hospices, quality reporting-wise. The hospice quality reporting program [...] - Hospice News:
Benchmark Yourself With This LOS Data
Want to see where you stack up against your peers when it comes to non-cancer [...] - Hospice News:
Check Out This Educational Resource
If you’re seeking educational materials to introduce the concept of palliative care to your patients, [...] - Hospice News:
Data Mining To Drive Investigations
If your billing patterns make you stick out like a sore thumb, you may see [...] - Hospice News:
Make Sure Your Records Are Legible
If paper records make up any part of your charting system, you’d better pay attention [...] - Reader Question:
Nail Cancer Codes Under ICD-10
Tip: You’ll need to look for greater specifics under the new coding system. [...]