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:

  • pam bondi

Florida AG Arrests Dentist and Office Manager for More Than $50,000 in Medicaid Fraud

February 8th, 2018|Comments Off on Florida AG Arrests Dentist and Office Manager for More Than $50,000 in Medicaid Fraud

Attorney General Pam Bondi and the Pembroke Pines Police Department arrested a dentist and their office manager for defrauding the Medicaid program out of more than $50,000.

Read the full story here.

  • Babiner_Dentist.2e16d0ba.fill-1200x630-c0

Bucks County dentist charged with $1.5M Medicaid fraud

February 5th, 2018|Comments Off on Bucks County dentist charged with $1.5M Medicaid fraud

Ilya Babiner, a Bucks County dentist, was charged Wednesday with 55 third-degree felony counts. Allegedly, the dentist filed a number of claims to the Medical Assistance Program between 2014 and 2016 seeking compensation for $1.5 […]

  • scripps-health

Scripps will pay $1.5M to settle billing fraud case

January 25th, 2018|Comments Off on Scripps will pay $1.5M to settle billing fraud case

Scripps Health in San Diego has agreed to settle allegations it violated the False Claims Act (paying $1.5 million), according to the Department of Justice. This resolves the allegations that Scripps had billed Medicare and […]

  • Orthopaedic-Surgery

CPT 2018 Changes for Orthopaedic Surgery

January 15th, 2018|Comments Off on CPT 2018 Changes for Orthopaedic Surgery

CPT 2018 Changes for Orthopaedic Surgery: It’s all about that Spine……almost

By Heidi Stout, CPC, COSC, CCS-P

 

Not much will change for orthopaedic surgery coding in 2018.  Most of the changes in CPT 2018 to the Musculoskeletal […]