Medicare Compliance & Reimbursement

Take a look at these tools to update your coding compliance plan.

Never underestimate the importance of a rough draft. Having an upfront, comprehensive compliance plan that is followed up with a pre-claim checklist puts you ahead of the claims game while also giving you piece of mind. Taking a second look at your claims, double-checking that the notes are in line and the codes match up will save you time and money.

Once you fully educate your staff on the nuances of Medicare fraud, consider putting these ideas into practice to avoid future coding errors:

• Implement an office compliance plan
• Educate staff on EHR best practices 
• Utilize certified vendors to ensure your health IT tools are compliant
• Audit your pre-claim and post-claim process
• Ensure that all personnel understand what’s at stake

Tip: “Practices that use third-party billers should meet with them and review how claims are coded and submitted,” suggests John E. Morrone, Esq, a partner at Frier Levitt Attorneys at Law in Pine Brook, NJ. “Many Practices do not realize that they are ultimately responsible for claims coded and submitted on their behalf.”