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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CMS Selects Primary Care Payment Model Participants

November 24th, 2020|Comments Off on CMS Selects Primary Care Payment Model Participants

CMS selects primary care payment model participants According to Becker's Hospital Review, "CMS chose 916 primary care practices and 37 regional health plan partners as participants in its new payment model called Primary Care First. [...]

OIG Tags Arizona Hospital for Erroneous Billing

November 12th, 2020|Comments Off on OIG Tags Arizona Hospital for Erroneous Billing

OIG Tags Arizona Hospital for Erroneous Billing Flagstaff (Ariz.) Medical Center failed to comply with Medicare billing requirements for three of 100 inpatient and outpatient claims reviewed by HHS' Office of Inspector General, according to [...]

Neurosurgeon Medical Practice Director to Pay Over $1 Million

November 12th, 2020|Comments Off on Neurosurgeon Medical Practice Director to Pay Over $1 Million

Neurosurgeon Medical Practice Director to Pay Over $1 Million Neurosurgeon Medical Practice Director to Pay Over $1 Million to Resolve False Claims Act Liability Arising from Billing of P-Stim Devices. PHILADELPHIA – First Assistant United [...]

New Mexico Physician and Practice Settle Case Involving False Claims

November 12th, 2020|Comments Off on New Mexico Physician and Practice Settle Case Involving False Claims

New Mexico Physician and Practice Settle Case Involving False Claims The settlement agreement resolves allegations that Dr. Reddy submitted claims for Healthcare Common Procedure Coding System (HCPCS) code 93965, when those claims were for a [...]