GENCO HEALTHCARE​ MANAGEMENT MEDICARE COMPLIANCE, AUDITS, MEDICAL BILLING

The International Classification of Diseases, “ICD Codes” were originally developed to track how people died. In 1948, just after the creation of the World Health Organization, a committee was put together to establish one version to represent all countries. Subsequently ICD codes were used to track diseases and injuries and to find patterns that might show an epidemic could be coming, as well as to track the general health of people. Today ICD codes are not only used for thi

In this third in our series of Blogs asking the question “Is your practice ready for a Medicare audit?” we continue our discussion of the critical importance of the PT/OT Evaluation. Medicare assigns significant weight to the patient information gathered and presented by the therapist during The Initial Evaluation. The initial evaluation records objective measurable data of the patient’s impairments to establish the baseline for assessing expected rehabilitation potential, se

It is each Medicare provider’s responsibility to read and fully understand the rules and regulations that have been established for their specialty in Local Coverage Determination (LCD’s) and other official communications. In the event of an audit or other review of your claims, it is prudent for a practice owner to expect that Medicare’s auditors will follow these policies to the letter; in every case. The old adage “If you did not write it, you did not do it” clearly appl

Each year the Office of Inspector General releases their action plan for the following 12 months. It is the ultimate To Do List; giving us insight into where they will be dedicating resources. Not surprisingly, the OIG is looking at areas of high utilization, improper or incomplete documentation, and providers and suppliers billing for services that are not medially necessary. They have targeted individual providers, practices and facilities across many medical specialty a