Is Your Billing Profile Setting You Up for an Audit?

Описание: JOIN ChiroSecure Malpractice Insurance for another exciting episode of GROWTH WITHOUT RISK as health law attorney Mike Miscoe of Miscoe Health Law PRESENTs:

Title:  Is Your Billing Profile Setting You Up for an Audit?

Post-Payment Audit Risk - What does your billing profile tell a payer looking for money to recover?
 
Outline:
Basis to Initiate a Post Payment Audit
1 Data Profiling
a Medical Necessity – Freq of Care Analysis
b Medical Necessity – ICD-10 Analysis
c Medical Necessity – Duration of Care Analysis
d Problematic Code Pairs.
 
2 Solutions
a Accurately diagnose condition causing symptoms.  Get rid of your short list of DX codes.
b Utilize established treatment protocols and choose therapy for each DX code and outline those choices in a detailed treatment order.
c Enforce patient compliance with visit schedule. Non-compliance means not medically necessary.
d Avoid consistent patterns in coding:
                 i.      CMT level
                 ii.      Unbundling manual therapy/massage
                 iii.      Extremity CMT
                 iv.      Doing the same therapies on all patients
                 v.      Too many E/M services
e Get in – show results (2-3 weeks at 3 times per week) and get out – moving the patient to non-covered palliative, supportive, preventive, maintenance or wellness care for cash.

If you can't make it you can get a copy of the transcript by texting GROWTH to (480) 500-6574.