Consolidating your Facilities Audit Losses

In my recent article “your audit losses begin in medical records” I discussed the role of the release of information officer in the dramatic impact that they can have upon audit losses. In this series we want to more deeply delve into how to consolidate your audit...
Eliminating Audit Denials

Eliminating Audit Denials

Your Audit Losses – Step One Of all the sites I’ve ever consulted for there is always the same pattern and posture with auditing. Some are better than others but all have divided the audit losses into generally three categories. 1. Business Office Denials 2....

The Internal Medical Auditor & Contracting Department

In the last few years of servicing the needs of our clients a theme that comes through strongly is to un-silo departments and get them talking again. One of the big disconnects that we see is between the internal auditor in the contracting department. Our intention in...

Aetna Response To Argument CMS Rule 2202.6

Many of you are familiar with Aetna’s denial based on CMS rule 2202.6. Here”s a recent response Medlinks provided to one of our clients. ABC Hospital Health System bills according to CMS guidelines and rules with no delineation between payers, either government or...

Medica Once in a Lifetime Policy

Once in a Lifetime Procedures Summary This policy limits the frequency of reimbursement for certain identified procedures to once in the patient’s lifetime. Once in a Lifetime Procedures, by the nature of their description, can be performed only once in a patient’s...

Violation of your Medical Audit Policy

Recently one of our hospital clients had a Third Party Audit Firm sneak a request for records past a new person. In my article titled “Your Losses Begin in Medical Records” you’ll see that releasing medical records needs to be carefully considered. In any case these...