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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Under Michigan’s New Medicare RAC Regime, Physician Services Are the Initial Primary Target

September 5th, 2017|Comments Off on Under Michigan’s New Medicare RAC Regime, Physician Services Are the Initial Primary Target

An announcement came back in back in October 2016 from the Centers for Medicare & Medicaid Services (CMS). It announced that it had awarded to various entities the next round of contracts to serve as […]

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Civil Fraud Case Settlement from Fredericksburg Hospitalist Group amounts to $4.2 Million

September 1st, 2017|Comments Off on Civil Fraud Case Settlement from Fredericksburg Hospitalist Group amounts to $4.2 Million

Along with 14 of its member shareholders, Fredericksburg Hospitalist Group has agreed to pay nearly $4.2 million to settle a federal False Claims Act case brought under the qui tam whistleblower provisions of the FCA.

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Medical Practice Agrees To Resolve Allegations Of Overbilling Medicare

August 28th, 2017|Comments Off on Medical Practice Agrees To Resolve Allegations Of Overbilling Medicare

St. Agnes Healthcare in Baltimore, Maryland has agreed to pay the United States a sum of $122,928 to resolve issues under the False Claims Act. These allegations allege that they submitted false claims to Medicare […]

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Due to Improper Billing, Healey Returns $500,000 in Settlement With a Springfield Dentist

August 25th, 2017|Comments Off on Due to Improper Billing, Healey Returns $500,000 in Settlement With a Springfield Dentist

Massachusetts Attorney General Maura Healey announced today a settlement with a pediatric dentist in Springfield. Healey’s office returned $500,000 to MassHealth, the state’s Medicaid program, resolving claims that improper billing for services occurred.

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