Thanks to Report on Medicare Compliance for permission to reprint this article. Recently Christopher Baggott, CEO of Medlinks Cost Containment, Inc. and Medlinks Staffing LLC. was interviewed by the Report on Medicare Compliance on the issue of medical audits. Our...
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...
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...
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...
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,...
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....
