You may use Experian, Equifax, TransUnion, Standard & Poors or Dun & Bradstreet. Posted By John Allman (Reposted for)

Please share.  Don’t miss a deadline so simple that could exclude you from participating!

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

1.  Outpatient Observation Billing

2.  Critical Access Hospitals:

A.  Distance to nearest, non-critical access hospital

B.  Herceptin and other Chemo Drug quantity

3.  Hospice because 82% of patients do not meet criteria to be admitted to hospice.

4.  Incident to Services by non-qualified personnel.  Even Blue Cross and Blue Shield is recouping and extrapolating on commercial claims for mid-level practitioner billing.  Make sure modifier is used when appropriate and the mid-level meets the licensing requirements to provide the services billed.

5.  Off Label Prescriptions.  Physicians ordering a drug that is approved for Diagnosis A but the drug is used for diagnosis B.

6.  Home Health-but not specific because they are going to review 2010 billing before they decide.

7.  Dialysis and ESRD Drug costs.  What is the drug cost to the provider versus the reimbursement.

8.  Contracts providers have with other providers/facilities.  Make sure you have a health care attorney to review the contract before executing because the health care attorneys are familiar with the Stark and Anti-Kickback provisions which typically the corporate business attorney does not have to consider.

9.  Checking employees, vendors, and providers against Sanction Databases MONTHLY.  You may find the federal links on my website.  The states have their own links.

10.  NY Medicaid reduced the annual revenues to $500K in Medicaid/Medicaid HMO/Managed Care Organizations (MCO) funds for compliance program requirement.

11.  Compliance Program Requirement under Federal Deficit Reduction Act that required all healthcare providers to have a compliance program in place by 2007 if their annual billing revenue of Federal and State reimbursement was $5M or more.  This would include Medicare, Medicaid, Tricare, Federal Employee programs and respective HMO or MCO.

12.  As of 2013 a healthcare compliance program is required for all providers billing Federal or State plans no matter what the annual billing revenue may be.  This would include dental practices because they bill Medicaid!

13.  Overpayments must be disclosed and refunded within 60 days of identification that it is an overpayment.  Failure to refund this money can result in “False Claims” charges and penalties.  Ensure you have someone that is accountable for working your credit balance reports monthly.  Keep documentation of these reviews and refunds issued as a result in a manner that can easily be explained and found.

The OIG Work Plan can be used to determine risk analysis, structure audit plans, and determine growth opportunities.

Do you have a Healthcare Compliance Program?

Do you review the OIG Work Plan Annually?

What else do you review to determine your audit plan?

We can help you analyze the status of your healthcare compliance program and ensure you have focused on the correct risks for your business model.  We are the compliance expert with a vast history and a cost effective way to ensure your compliance program is operating and managing your risk.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

Ms. Spain introduced Beacon, which is at no additional cost to a general LabCorp account!  Beacon is virtual access to lab results and providers up to 2 years of lab history for the patient, no matter who ordered previous tests on file.  This will save the payers money and provider the physicians the ability to make decisions and treatment recommendations quicker for better quality patient care.  The patients many times do not remember what kind of tests other physicians orders, the results, or which physician ordered it.

This is an innovative step for LabCorp right at the time when Medicare is trying to implement Accountable Care Organizations which is all about quality care for the least expense by managing medical costs.

Contact Toni Spain for more information on this product that will change your office.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

On October 4th, D.R. Saur will host a panel discussion to shed light on the many facets of building a comprehensive strategy to fulfill that role. We will have legal, financial, and insurance experts to answer your questions. We still have a few seats available for both the 9:00 and 12:00 noon sessions. A light meal will be served as well for your convenience.

Seating is limited, so if you and/or your parent would like to join us, please contact Stephanie at DR Saur at 214 559 3944 to reserve your spot. Please see the attached invitation for all the details.

Posted on behalf of Kelly Kunst. One of the most fantastic ladies and perfect to be one of the speakers and head up this panel. She is an expert in financial services, but her passion is educating people on the tough topics.

Medical Auditing Solutions LLC is excited to announce the release of our new service called “Compliance University.”  The Compliance University focuses on the healthcare regulatory compliance annual training requirements for all employees.  HIPAA requires annual privacy and security training for all employees (2003 & 2010) respectively.  Compliance (billing, contracts, and relationships) is required as part of the Healthcare Reform Act and the Patient Protection Accountability and Affordable Care Act due 2013.  This training is only one aspect of an effect Compliance program.  Privacy and Security is primarily monitored, audited and investigated by HHS and Office of Civil Rights.  Compliance is primarily monitored, audited, and investigated by CMS, OIG, HHS, FBI.  The monitoring, auditing, and investigation may start in other federal and state government areas.

All programs are general in nature and meant for any type of health care providers.  They are between 40 minutes and 1 hour.  Each program is followed by a test of comprehension, an evaluation that is required to receive the completion certificate.  The Compliance University will provide the company with status, completion, grade reports.  We have additional programs to be released within the next few weeks as well to complete the set.  The programs contain examples and explanation for various health care industries so the knowledge obtained can be applied in any setting.

We look forward to helping you with your compliance program training as well as other areas of development and tracking that you may need to complete.  Check out our website at www.MedicalAuditingSolutions.com and Compliance University.  Mention this press release “PRESS” and receive 10% discount.

FBI-Federal Bureau of Investigation

HHS-Health and Human Services

OCR-Office of Civil Rights

OIG-Office of Inspector General

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

We know the sacrifice that Caregivers make for their loved ones. Our organization looks for resources to help providers and caregivers  care for your loved ones. We have met with AFFECTS a Texas based entity that is well known for Innovation, Creativity and Entrepreneurship, and definitely not a traditional company by any means.

We hope you are excited!  Mr. Ray Ashton who is the Founder of this highly progressive company out of Houston is very passionate about his innovative training.  This life long mission was sparked because his grandmother passed away after years of suffering from Dementia.  Read more about Mr. Ashton.  He actually coined the term,  “Preventive Wellness” about 22 years ago.  His healthcare company, STAR Preventive Wellness (AFFECTS LLC), is training the Healthcare professional across the country with main focus on Geriatric and Early Stage Dementia, in particular.  His idea is to train the Communities’ own staff (or individuals) including RN’s, LVN’s and just about anyone who works with Seniors including Case Managers, Administrators or Social Workers. His 8-Hour CEU training is really a must for anyone who works at Memory Care, Assisted Living or Skilled Nursing communities.

One is being planned for the Dallas metroplex for July, with details TBA soon.  A convenient location for those attending is being sought since this is a large metroplex, price and program length will remain the same.  Please contact Star10R  at star-10r-dallas@affects.biz or star@affects.biz  for interest in the Dallas or Houston areas.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

Read more and register at  Lung Center University  Please contact Lung Center University direct for any questions and information.

Speakers include Greg Shockey, President of America, Mel Arenas, RT & Sr. VP of Lung Centers of America, Jim Girard is the National Sales Manager for Schiller-America and Jan Jennings, President & CEO of American Healthcare Solutions.  This team of speakers has a very well documented and prestigious career in the health care industry.  You can read the extensive biography on each speaker under the agenda.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

Angela Miller speaking for Zirmed Financial Workout Webinar Series

April 20, 2011

VGM’s Heartland Conference

June 8 – 9, 2011

Texas Osteopathic Medical Association

June 17, 2011  10am-noon

Medtrade Fall 2011

October 26 & 27

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KY Medical Equipment Suppliers Associate (KYMESA)

November 9, 2011 – Compliance Program Implementation

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Paychexs – Irving Texas office contact Christina Rossini to register.

December 6, 2011 – Compliance Program Requirements

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Medtrade Spring 2012

April 10-12, 2012

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American Association of Osteopathic Executives

May 20-22, 2012

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Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.