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High-Risk Areas in Medicare Billing: Compliance Auditing Tools for Hospitals and Health Systems

High-Risk Areas in Medicare Billing: Compliance Auditing Tools for Hospitals and Health Systems

 
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Charter Subscription Price: $687
Format: Annual subscriptions include access to a password-protected Web site, the right to adapt downloadable compliance tools, and 12 issues of the monthly newsletter
Pub Code: HRM

Billing errors are driving almost all large repayments made to the U.S. government by hospitals ... and recovery audit contractors (RACs) identified and corrected $357 million in FY 2007 Medicare overpayments in three states alone. 

High-Risk Areas in Medicare Billing — a user-friendly Web site packed with valuable how-to tools (checklists, worksheets, policies and procedures) on scores of risk areas — will help insulate your facility from multi-million-dollar Medicare repayments and compliance hassles such as delayed payments, rejected claims and other burdensome red tape from CMS.

As a Charter Subscriber to High-Risk Areas in Medicare Billing, you’ll know what areas CMS and the OIG are targeting and how to audit your own hospital’s compliance.  And you’ll ensure that each department and all staff affecting patient billing — registration, health information, billing and patient accounts, IT and, of course, professional staff — understand Medicare regulations fully and have the tools they need to stay in compliance.

Your subscription includes three valuable services:

  1. One year of subscriber-only Web access … with risk-specific guidance and the right to download hundreds of highly practical tools (well-organized for quick retrieval) to adapt and use in your own hospital’s compliance programs.
  2. E-mail alerts when major news breaks and/or the Web site has been updated (a minimum of monthly), and
  3. A monthly Current Developments newsletter (delivered in print and e-mail, and archived on the Web), which tracks CMS transmittals, related payer alerts and other government fraud alerts ... and includes strategic articles on topics like mandatory implementation of NPI or drug administration billing problems.

High-Risk Areas in Medicare Billing will save you an enormous amount of time and expense ... and help you  understand the nuances of a long list of high-risk billing issues in these and other areas:

  • Observation and admissions
  • Length-of-stay issues
  • Present-on-admission indicators
  • Medical necessity and documentation
  • Drugs and biologicals
  • Clinical trial reimbursement
  • Outpatient procedure coding
  • Transfers and discharges
  • Medicare cost reports
  • Medicare secondary payer
  • Modifiers
  • Medical devices

Among the questions answered for each high-risk area: What are the rules? What are the risks? What tools should I use to audit and monitor the area? How do I handle identified problems? What best practices can keep me in compliance? Where do I find all related regulatory guidance and CMS transmittals?

And you’ll have the information you need to reduce potentially fraudulent claims in special types of facilities that pose their own unique problems, such as: skilled nursing facilities; teaching hospitals; inpatient/outpatient rehab hospitals; ambulatory surgery centers; long-term care hospitals; and critical access hospitals.

Make sure you have the tools you need to tackle high-risk billing challenges before they become costly Medicare compliance problems. Subscribe to High-Risk Areas in Medicare Billing today!

 

Written By

Written by Strategic Management Systems, Inc. (SMSInc), one of the nation’s most reputable and experienced consulting firms, and managed by Atlantic Information Services, Inc. (AIS), which has been publishing industry-leading news and strategies for hospital compliance officers for more than 15 years, led by Nina Youngstrom’s weekly Report on Medicare Compliance.

 

Written For

  • Billing Directors
  • Medical Records and HIM Managers
  • Coding Managers
  • Patient Accounting Directors
  • Internal Auditors
  • Compliance Auditors
  • IS Directors
  • CFOs and Finance Managers
  • CPAs, Attorneys and Consultants

 

Shipping Information

When you sign up, we'll e-mail you a temporary username and password so that you can access all of the information on the Web site. (You can change the username and password the first time you log onto the site.)

Monthly print newsletters are mailed 1st class through the U.S. Postal Service. You should receive your first issue within 5-7 business days of your order.

A one-time $5 shipping and handling charge will be applied to your order.

 

Related Publications

Report on Medicare Compliance
63 Billing and Coding Strategies for Medicare Compliance
A Guide to Auditing and Monitoring HIPAA Privacy Compliance
Medicaid Compliance News

 


For further information call 800-521-4323 or e-mail customerserv@aispub.com
 
Print an order form:
If you do not wish to place your order online, click here to download a printable order form (PDF file), then submit your order via fax or mail, as directed on the form.

Related Publications

Report on Medicare Compliance

63 Billing and Coding Strategies for Medicare Compliance

A Guide to Auditing and Monitoring HIPAA Privacy Compliance

Medicaid Compliance News

 


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