Medical Coding Audits and Compliance

Cerner Falls but Remains Dominant Alongside Epic for EHR Market Share

By |2020-11-12T21:46:37+00:00November 12th, 2020|

Cerner Falls but Remains Dominant Alongside Epic for EHR Market Share Epic and Cerner have been the only vendors to add hospital market share each year since KLAS started tracking the market in 2010. However, Cerner experienced a net decrease in market share for the first time since 2010, according to a recent KLAS Research [...]

United States Joins False Claims Act Lawsuit against California Doctor

By |2020-11-10T17:38:51+00:00November 10th, 2020|

 United States Joins False Claims Act Lawsuit against William M. Kelly, M.D. Inc. and Omega Imaging Inc. United States Joins False Claims Act Lawsuit against William M. Kelly, M.D. The United States has partially intervened in a False Claims Act lawsuit against William M. Kelly, M.D. The government intervened as to allegations that the defendants, [...]

Villages Dermatologist Agrees To Pay More Than $1.7 Million To Settle False Claims Act

By |2020-11-10T17:38:25+00:00November 10th, 2020|

Villages Dermatologist Agrees To Pay More Than $1.7 Million To Settle False Claims Act Liability For Inflated Medicare Claims Villages Dermatologist Agrees To Pay More Than $1.7 Million To Settle False Claims Act Liability For Inflated Medicare Claims Orlando, FL – United States Attorney Maria Chapa Lopez announces today that Dr. Thi Thien Nguyen Tran [...]

Wise Psychiatrist Pleads Guilty to Federal Health Care Fraud Charge

By |2020-11-10T17:37:59+00:00November 10th, 2020|

Wise Psychiatrist Pleads Guilty to Federal Health Care Fraud Charge According to court documents, from 2010 to 2016, Ehtesham devised a scheme to defraud Virginia Medicaid and Medicare by billing for individual office visits when she often saw patients in groups of two to four patients per visit. The investigation of the case was conducted [...]

Best Practices When Outsourcing Revenue Cycle Management

By |2020-11-10T17:37:33+00:00November 10th, 2020|

Best Practices When Outsourcing Revenue Cycle Management The revenue cycle is a critical healthcare process, and its management is central to the business of healthcare. “It's an area where lots and lots of hospitals struggle and the difference between effective revenue cycle management and ineffective revenue cycle management is success or failure in the industry,” [...]

West Michigan Urogynecologist Sentenced To Prison For Healthcare Fraud And Adulteration Of Medical Devices

By |2020-11-10T17:36:56+00:00November 10th, 2020|

West Michigan Urogynecologist Sentenced To Prison For Healthcare Fraud And Adulteration Of Medical Devices GRAND RAPIDS, MICHIGAN — U.S. Attorney Andrew B. Birge announced today that U.S. District Judge Janet T. Neff sentenced Roger D. Beyer, M.D., to 57 months of incarceration for his involvement in a conspiracy to commit healthcare fraud and 12 months [...]

ER Physicians Accuse UnitedHealth of Illegally Underpaying Claims

By |2020-11-10T17:36:32+00:00November 10th, 2020|

ER physicians accuse UnitedHealth of illegally underpaying claims Several emergency room physician practices in New York have filed a federal lawsuit alleging UnitedHealth Group and MultiPlan conspired to underpay out-of-network ER providers. In their federal complaint, filed Nov. 2, five ER physician groups allege UnitedHealth failed to pay them the "reasonable" rate for out-of-network claims. [...]

Memphis Physicians Agree To Pay More Than $340,000 for Alleged Overbilling

By |2020-11-10T17:36:09+00:00November 10th, 2020|

Memphis Physicians Agree To Pay More Than $340,000 for Alleged Overbilling Doctor Shoaib Qureshi, Doctor Imran Mirza, Memphis Primary Care Specialists, Lunceford Family Health Center, and Getwell Family Medicine agreed to pay $341,690 to resolve allegations that they violated the False Claims Act by knowingly charging Medicare for services rendered by nurse practitioners at the [...]

Ambulance Provider Agrees to Settle False Claims Act Allegations

By |2020-11-10T17:35:36+00:00November 10th, 2020|

https://www.justice.gov/usao-edva/pr/ambulance-provider-agrees-settle-false-claims-act-allegations An ambulance transportation company that operates throughout Virginia has agreed to pay $110,000 to settle allegations that the company submitted false claims to Medicare for ambulance transports, in violation of the False Claims Act. The United States government alleged that, for a two-year period between 2014 to 2016, some of the claims submitted for [...]

Lexington Foot and Ankle Center Agrees to Pay $750,000 to Resolve Allegations of Violations of the False Claims Act

By |2020-11-10T17:35:09+00:00November 10th, 2020|

https://www.justice.gov/usao-edky/pr/lexington-foot-and-ankle-center-agrees-pay-750000-resolve-allegations-violations-false Lexington-based podiatry practice Lexington Foot and Ankle Center, PSC (“Lexington Foot & Ankle”) and Dr. Michael Allen have agreed to resolve civil allegations that they violated the False Claims Act, a federal law that prohibits the submission of false or fraudulent claims to the federal government, agreeing to pay the United States $750,000.