📢 📢 📢Come see our team at the Healthcare Payment & Revenue Integrity Series HPRI East in Boston, May 22-23, 2024. We will have a booth for you stop by and say hello. Also, check out the Healthcare Fraud Shield session with ♦Karen Weintraub, MA, AHFI, CPC-P, CPMA, CDC♦ on Identifying and Addressing Common Billing and Coding Errors. #hprieast #hcfs #fwa
Healthcare Fraud Shield’s Post
More Relevant Posts
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Let’s see in detail about healthcare fraud and abuse and how Zee medical billing detects and prevents those frauds: https://lnkd.in/dkQvAiCt
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With CMS, change is the only constant. #ECS Can help you keep up with the pace of change. Ask us how we can help you. #mspcompliance #conditionalpayments
In an industry filled with change and increased regulation, failure to comply with Medicare guidelines or submit required #Section111 data can be costly. Finding the time to track #ConditionalPayment Demand Letter disputes, appeals, or staying up to date with the latest requirements is overwhelming. You need an expert partner to inform and provide custom solutions for Claims Resolution, Medicare Compliance, Outcome Management and Mandatory Insurer Reporting. ExamWorks Compliance Solutions is that partner: https://ow.ly/PhC450QVj6p #ECS #MSPCompliance #MedicareCompliance #Medicare#MandatoryInsurerReporting
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In an industry filled with change and increased regulation, failure to comply with Medicare guidelines or submit required #Section111 data can be costly. Finding the time to track #ConditionalPayment Demand Letter disputes, appeals, or staying up to date with the latest requirements is overwhelming. You need an expert partner to inform and provide custom solutions for Claims Resolution, Medicare Compliance, Outcome Management and Mandatory Insurer Reporting. ExamWorks Compliance Solutions is that partner: https://ow.ly/PhC450QVj6p #ECS #MSPCompliance #MedicareCompliance #Medicare#MandatoryInsurerReporting
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Most common denial codesCO 4: Required modifier missing CO 11: Error in diagnosis coding. CO 15: Missing or invalid Authorization number CO 16: Lacks information needed for adjudication CO 18: Duplicate claim CO 22: coordination of benefits CO 27: Expenses incurred after the patient's insurance expired CO 29: limit for filling expired CO 45: changes exceed fee schedule CO 97: Service already adjudicated CO 167: Diagnosis not covered.
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Most common denial codes. CO 4: Required modifier missing CO 11: Error in diagnosis coding. CO 15: Missing or invalid Authorization number. CO 16: Lacks information needed for adjudication. CO 18: Duplicate claim. CO 22: coordination of benefits. CO 27: Expenses incurred after the patient's insurance expired. CO 29: limit for filling expired. CO 45: changes exceed fee schedule. CO 97: Service already adjudicated. CO 167: Diagnosis not covered.
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At Capital Services, we put patients first! 🤝 Understanding & Sensitivity: We recognize the unique nature of each patient's billing situation and align closely with Hospital procedures. Our aim? Helping patients meet their obligations with dignity and responsibility. 🛡️ Compliance & Trust: We adhere strictly to local and national FDCPA & HIPAA guidelines. You're in safe hands with us! 📞 Respectful Communication: Say goodbye to incessant calls. We motivate patients to communicate, offering manageable payment plans at every step of the recovery process. Experience the Capital Services difference. Fewer complaints, more resolutions! ✨https://buff.ly/46oCEJZ #MedicalBilling #PatientFirst #ComplianceMatters
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🛡️ Strengthen Your Healthcare Practice Against Billing Fraud with RevPro Healthcare 🛡️ Protecting your medical practice from billing fraud is crucial for both financial health and patient trust. At RevPro Healthcare, we're dedicated to crafting a secure, compliant, and trustworthy billing environment. Our approach includes developing a tailored compliance program, continuous team education, routine audits for accountability, leveraging advanced fraud detection technology, and fostering transparency. We also emphasize the importance of engaging patients and networking with peers to share insights and strategies. With these pillars, we support healthcare practices in building a robust defense against billing fraud, ensuring efficiency, compliance, and the preservation of trust. Let’s safeguard the integrity of healthcare billing together. 🏥💼 #BillingFraudPrevention #HealthcareIntegrity #ComplianceFirst #RevProHealthcare Learn more here. https://bit.ly/43JYBmP
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Great lawyering and trial preparation. Using the objectively reasonableness standard of Ruan is a great win.
Thank you to Law 360 for including my article about the important recent acquittal of Dr. Ron Elfenbein. As outlined in the article, a judgment of acquittals is rare, but a post-verdict judgment of acquittal is a unicorn. In granting an acquittal, the court found that Dr. Elfenbein’s selection of the highest reimbursing CPT codes in connection with COVID testing was reasonable and that, even if Dr. Elfenbein intended to obtain the maximum reimbursement from healthcare plans by consistently selecting the highest reimbursing codes, at its core, the healthcare fraud statute requires proof of falsity. And so, the government could not collapse the elements of intent and falsity to prove each element of the offense of healthcare fraud beyond a reasonable doubt. #healthcarefraud#COVID-19#acquittal#jurytrials#fightfordoctors#
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Lien Resolution | Medicare | Medicare Advantage | ERISA | Private Insurance | Medicaid | Military | VA | Tricare | FEHBA | Disability | Hospital and Provider Bills
Medicare Conditional Payment Tip: 🎯 Section 1862(b) of the Social Security Act offers a "best interest of the program" waiver, evaluated by CMS itself. It's another strategic route for your Medicare compromise/waiver request. Let Synergy's team of industry leading Medicare Conditional Payment resolution experts secure a “Medicare Refund” for your client. #MedicareWaiver #CMS #MedicareRefund #Synergy
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Does your organization review the annual OIG-DOJ HFAC reports? Admittedly 139 pages is a lot to process. Pages 15-36 provide an informative snapshot of the most recent recoveries, settlements, and fraud trends in healthcare. More importantly, these reports highlight the return on investment (ROI) of hard-earned taxpayer dollars recovered from fraudsters and fraud schemes. For example, In FY2022 the ROI was nearly 3 to 1. #texasoversight #medicare #hcfac #hhsoig #medicarefraud #fraudtrends
