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!

Latest Blog Posts:

  • DJI_0017

Maryland Treatment Centers Agrees to Pay $500,000 to Resolve Allegations That It Submitted Claims for Services That Were Undocumented or Not Provided

November 21st, 2018|Comments Off on Maryland Treatment Centers Agrees to Pay $500,000 to Resolve Allegations That It Submitted Claims for Services That Were Undocumented or Not Provided

Maryland Treatment Centers has consented to pay the United States $500,000 to settle charges under the False Claims Act that it submitted false cases to the United States for psychological wellness and substance misuse benefits […]

  • CMS-logo-2

Clinician Letter Reducing Burden Documentation

November 19th, 2018|Comments Off on Clinician Letter Reducing Burden Documentation

  • CMS_0

Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2019

November 17th, 2018|Comments Off on Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2019

Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2019

On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates […]

  • 2017-12-12-CMS-red

CMS says it will recover $1B in ill-advised Medicare installments by 2020

November 15th, 2018|Comments Off on CMS says it will recover $1B in ill-advised Medicare installments by 2020

CMS said it is ready to hook back $1 billion from Medicare Advantage associations by 2020 through far reaching reviews, as indicated by a proposed standard.

Here are five things to know:

1. The standard, set to […]