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:

Concern Raised Over Estimated Billions Shown in Chart Reviews

December 13th, 2019|Comments Off on Concern Raised Over Estimated Billions Shown in Chart Reviews

The Office of the Inspector General of the United States undertook a recent study in which they reviewed a myriad of Medicare Advantage organizations (MAOs). There were concerns that these MAOs may be using chart [...]

Office Manager and Wife of Conway Arkansas Doctor Arrested for Medicaid Fraud

November 27th, 2019|Comments Off on Office Manager and Wife of Conway Arkansas Doctor Arrested for Medicaid Fraud

Leslie Rutledge, an Attorney General for the State of Arkansas, announced today that a Conway Optometrist's Officer Manager had been arrested and charged with for defrauding almost $600K from the Arkansas Medicaid Program during the [...]

Lenox Hill Hospital Pays $12.3 Million Settlement For Submitting Fraudulent Medicare Claims

November 25th, 2019|Comments Off on Lenox Hill Hospital Pays $12.3 Million Settlement For Submitting Fraudulent Medicare Claims

The US Attorney for Manhattan, New York, and a Special Agent for the OIG's New York Regional Office, announced today that the US Federal Government has settled a civil fraud suit against Lenox Hill (a [...]

Company Owner Goes to Jail for Medicaid Fraud

November 6th, 2019|Comments Off on Company Owner Goes to Jail for Medicaid Fraud

The owner of a transport company has pleaded guilty to fraudulently charging the good citizens of Massachusetts millions in false claims through the state’s Health Care Program known as MassHealth. The 59 year old Michael [...]