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:

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Medicare fraud by All Saints Anesthesiologists

October 23rd, 2018|Comments Off on Medicare fraud by All Saints Anesthesiologists

From 2011 to somewhere around 2014, Ascension All Saints Hospital’s contracted anesthesiology aggregate efficiently overbilled Medicare and Medicaid for many dollars, as indicated by a government claim. It was brought by an informant who trusts […]

Update: CMS’s Proposed Changes to the Physician Fee Schedule for 2019

October 17th, 2018|Comments Off on Update: CMS’s Proposed Changes to the Physician Fee Schedule for 2019

Following up on our September 4th, 2018 post “MGMA Opposes Proposal to Consolidate E/M Codes”, The Coding Network has been actively tracking the status of the sweeping changes to the Physician Fee Schedule for 2019 proposed […]

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Stuart Doctor Charged in Twenty-Six Count Federal Health Care Fraud Indictment

October 16th, 2018|Comments Off on Stuart Doctor Charged in Twenty-Six Count Federal Health Care Fraud Indictment

A specialist has been accused of submitting social insurance misrepresentation out of her training in Stuart, Florida. The U.S. Lawyer for the Southern District of Florida, Shimon R. Richmond, Special Agent in Charge, U.S. Division […]

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Medicaid and Medicare Telehealth Payments Fails to Meet Medicare Requirements

October 12th, 2018|Comments Off on Medicaid and Medicare Telehealth Payments Fails to Meet Medicare Requirements

OIG reviewed 191,118 Medicare paid distant-site telehealth claims, totaling $13.8 million, that did not have corresponding originating-site claims. The watchdog agency then reviewed provider supporting documentation to determine whether the services met Medicare’s requirements for […]