Policy Name 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 lifetime. Policy Statement In general, Once in a Lifetime Procedures involve the removal of an organ in the body. Example: A patient only has one appendix, […]
Here in Reno, Nevada for the combined conference of Certification Council for Medical Auditors (CCMA) and the American Association of Medical Audit Specialists (AAMAS). I’m honored and pleased to announce that I’ve been elected President for the CCMA org. The CCMA, formerly CMAS is the nationally recognized certification body for medical auditors. As 2015 to 2017 progresses we will be working on online testing, growth of the organization that includes […]
Here is the auditing group on LinkedIn. All things Medical Auditing will be discussed.
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 records were released under the false pretense of a quality review when in fact the review was a one sided desk audit followed by […]
New office is coming along. Medlinks is offerring solutions for providers and payers in the healthcare environment
As we explored previously in our first article stopping loss can occur. Here’s how it starts: Identify and consolidate your findings in these areas: 1. Government Audits 2. Commercial Audits 3. Business Office Denials Most sites will keep these areas separate, choosing to have the Government audits handled by one person, the commercial audits handled by another, and the business office denials handled by a third person or group. This […]
Finally Friday Show April 10, 2015
Finally Friday! Apr 10 2015 – SLIDES v2