Medical Coding Compliance Department Support

COMPLIANCE OFFICE SUPPORT

Many multispecialty healthcare systems, academic faculty practices, and large medical groups have established central Compliance Offices, usually staffed with small number of coders. They are responsible for compliance reviews of all of the many specialties and subspecialties represented by the practice’s physicians. Considering the unique clinical characteristics of each specialty and the complexity and differences of the coding rules and regulations between the various specialties, we are absolutely convinced that it is virtually impossible for one person to know it all. The fund-of-knowledge encompassing the totality of medicine is simply too vast. This is why physicians specialize, and is the very same reason why we organized The Coding Network along a similar specialty-driven structure. Experience has taught us, over and over, that matching the coder/auditor’s expertise to a specific specialty is the only way to assure maximal accuracy and compliance.

We can support your Compliance Office’s efforts very economically. Our audit findings have the additional credibility of being from an outside independent firm with specialty-specific expertise. Your employed compliance staff can then focus their energy and resources on working one-on-one with each provider to improve the quality of their medical record documentation. This totally changes the dynamics of the provider-compliance relationship from one of adversarial “policing” to into one of teamwork to reduce legal risks and optimize revenues.

With our accuracy guarantee coupled with no monthly or annual minimums or “subscription fees,” we can cost-effectively support your Compliance Officer with no fixed expenses!

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Medicare overbilled by $41.9M – Mount Sinai Hospital

May 15th, 2017|Comments Off on Medicare overbilled by $41.9M – Mount Sinai Hospital

New York City: According to a recent OIG report, Mount Sinai Hospital failed to comply with Medicare’s billing requirements for 110 outpatient and inpatient claims reviewed by the office of Inspector General for the audit […]

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Dermatologist in Encino to Pay $2.7 Million

April 26th, 2017|Comments Off on Dermatologist in Encino to Pay $2.7 Million

Dr. Norman A. Brooks, M.D., the owner of The Skin Cancer Medical Center in Encino, has paid the United States nearly $2.7 million on April 10th to resolve allegations that he submitted bills to Medicare […]

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OIG Posts a Resource Compliance Guide & Enforcement Action

March 29th, 2017|Comments Off on OIG Posts a Resource Compliance Guide & Enforcement Action

You can use the links provided and go directly to the OIG material.

The OIG has developed free educational resources listed are to help health care providers, practitioners, and suppliers understand the health care […]

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1 in 4 health consumers have had their PHI stolen

February 21st, 2017|Comments Off on 1 in 4 health consumers have had their PHI stolen

26% of United States health consumers have had their PHI stolen from healthcare systems, according to the results of a study from Accenture, released in Orlando at HIMSS17. The study reveals that 50% of people […]