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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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 [...]

Anesthesia Place in Traverse City Will Now Pay $600K For Falsifying Claims to Medicare

October 15th, 2019|Comments Off on Anesthesia Place in Traverse City Will Now Pay $600K For Falsifying Claims to Medicare

According to the United States DOJ, Traverse Anesthesia Associates, along with several anesthesiologists are paying over $600K to resolve allegations that they consciously incorrectly submitted certain anesthesia claims to Medicare. Investigators mentioned that TAA and [...]

Doctor’s Practice to Pay Nearly $180K to Resolve False Claims Act Liability Regarding “P-Stim” Devices

September 24th, 2019|Comments Off on Doctor’s Practice to Pay Nearly $180K to Resolve False Claims Act Liability Regarding “P-Stim” Devices

First Assistant U.S. Lawyer Jennifer Arbittier Williams proclaimed that Richard P. Frey, D.O., and Physicians Alliance Ltd. (“PAL”) have agreed to pay nearly $180,000 to resolve liability underneath the False Claims Act for the alleged [...]