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:

The OIG calls out a CA Medical Group for Inaccurate Charges

September 12th, 2019|Comments Off on The OIG calls out a CA Medical Group for Inaccurate Charges

Santa Monica, California based Oceanside MedicalGroup did not comply with Medicare necessities when charging for psychotherapy services, in keeping with a report from Health and Human Service's OIG. The Office of Inspector General said none [...]

Medicare Advantage Supplier and Doctor to Pay $5 Million to Settle False Claims Act Allegations

August 14th, 2019|Comments Off on Medicare Advantage Supplier and Doctor to Pay $5 Million to Settle False Claims Act Allegations

Beaver Medical Group L.P. (BMG) and a doctor who works for it, Dr. Sherif Khalil, have agreed to pay a little over the amount of $5 million to resolve accusations that they falsely reported diagnosis [...]