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eClinicalWorks Fined For Failing To Comply With DOJ Settlement Agreement

The Inspector General of the Department of Health and Human Services fined eClinicalWorks $132K for violating a 2017 agreement which had required them to report patient safety issues with its EHR in a timely manner.

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By |August 7th, 2018|Medical Coding News and Recent Articles|Comments Off on eClinicalWorks Fined For Failing To Comply With DOJ Settlement Agreement

OIG Estimates Medicare Improper Payments at $3.7 million

The Office of Inspector General (OIG) reviewed 191,118 Medicare paid distant-site telehealth claims, totaling $13.8 million, that lacked corresponding originating-site claims. The watchdog agency then reviewed provider supporting documentation of these claims to determine if the services met Medicare’s requirements for reimbursement. 31% of the telehealth claims did not.

Now is the time to fully understand Medicare telehealth claim requirements and nail down its coding, and […]

By |August 6th, 2018|Medical Coding News and Recent Articles|Comments Off on OIG Estimates Medicare Improper Payments at $3.7 million

Medicare Cuts For Academic Hospitals

Scholastic and country healing centers will probably observe a cut in Medicare subsidizing if the CMS concludes a proposition to diminish repayment for more-complex patients, as indicated by a Moody’s Investors Service examination discharged Monday.

Under the CMS’ recently proposed installment structure, the organization needs to level installments for a few charging codes instead of paying […]

By |August 3rd, 2018|Medical Coding News and Recent Articles|Comments Off on Medicare Cuts For Academic Hospitals

Evaluation & Management Coding Handbook 2018

According to CMS, Evaluation and management (E/M) codes are the most frequently reported—and the most audited. In a study referred to by CMS, the OIG noted that 42% of claims for E/M services were incorrectly coded. Medicare reports a 65-70% error rate for codes 99215, 99223, and 99233. Upcoding and the misuse of modifier 25 are problematic. Widespread issues include the inherent […]

By |August 1st, 2018|Medical Coding News and Recent Articles|Comments Off on Evaluation & Management Coding Handbook 2018

Georgia Emergency Physicians Sue Anthem Over ER Policy

The MAG (Medical Association of Georgia), alongside the American College of Emergency Physicians, sued Anthem for payment denial of some emergency department services.

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By |July 30th, 2018|Medical Coding News and Recent Articles|Comments Off on Georgia Emergency Physicians Sue Anthem Over ER Policy

Southwest Orthopaedics Physicians to Pay Settlement

9 specialists from Southwest Orthopaedics (based in OKC) agreed to pay $670,000 to settle civil claims stemming from allegations they submitted false claims.

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By |July 25th, 2018|Medical Coding News and Recent Articles|Comments Off on Southwest Orthopaedics Physicians to Pay Settlement

Montana Hospital Employee Email Hacked

The email account of a Montana Clinic employee was hacked in May while they were oversas, potentially compromising  the information of over 8000 patients.

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By |July 23rd, 2018|Medical Coding News and Recent Articles|Comments Off on Montana Hospital Employee Email Hacked

Medicare Proposed Virtual Care Reimbursement

CMS made a series of suggestions to expand telehealth in its latest Medicare Physician Fee Schedule and Quality Payment Program.

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By |July 17th, 2018|Medical Coding News and Recent Articles|Comments Off on Medicare Proposed Virtual Care Reimbursement

Liberty Ambulance Service investigated for fraudulently billing federal agencies

Liberty Ambulance Service, located in Jacksonville, has agreed to a $1.2 million settlement. This is in response to allegations that it, for more than 10 years, fraudulently billed federal health benefits providers for transportation of patients.

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By |July 12th, 2018|Medical Coding News and Recent Articles|Comments Off on Liberty Ambulance Service investigated for fraudulently billing federal agencies

Allstate Files $2M Suit

Allstate, one of the largest insurance companies in the world, has filed 81 fraud lawsuits in New York since 2003. Most recently, the company filed another suit against 13 new corporations. This has been an attempt to cover $2 million in damages from the no-fault healthcare firms and their owners.

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By |July 9th, 2018|Medical Coding News and Recent Articles|Comments Off on Allstate Files $2M Suit