RAC Audit Defense

Have you been the unlucky subject of a RAC audit?  Are you being subjected to extrapolated recoupments and penalties?

Before you simply capitulate and pay them, it would be prudent to confirm their findings.  Writing a small check to The Coding Network might eliminate or reduce a large check to these “bounty hunters.”  Their auditors may not be intimately familiar with your specialty, and their commission-only structure certainly gives them an incentive to assert that you’ve made coding errors or that your records don’t support your claims.  There may be some gray areas in your charts that they interpret against you.  We can audit the same encounters or operations they examined, and our findings may give you the ammunition you need to mount a credible defense.

Call 888-CODE-MED to learn more.

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eClinicalWorks Fined For Failing To Comply With DOJ Settlement Agreement

August 7th, 2018|Comments Off on eClinicalWorks Fined For Failing To Comply With DOJ Settlement Agreement

The Inspector General of the Department of Health and Human Services fined eClinicalWorks $132K for violating a 2017 agreement which had required them to report patient safety issues with its EHR in a timely manner.

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OIG Estimates Medicare Improper Payments at $3.7 million

August 6th, 2018|Comments Off on OIG Estimates Medicare Improper Payments at $3.7 million

The Office of Inspector General (OIG) reviewed 191,118 Medicare paid distant-site telehealth claims, totaling $13.8 million, that lacked corresponding originating-site claims. The watchdog agency then reviewed provider supporting documentation of these claims to determine if the services met Medicare’s requirements for reimbursement. 31% of […]

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Medicare Cuts For Academic Hospitals

August 3rd, 2018|Comments Off on Medicare Cuts For Academic Hospitals

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Evaluation & Management Coding Handbook 2018

August 1st, 2018|Comments Off on Evaluation & Management Coding Handbook 2018

According to CMS, Evaluation and management (E/M) codes are the most frequently reported—and the most audited. In a study referred to by CMS, the OIG noted that 42% of claims for E/M services were incorrectly coded. Medicare reports a […]