Accountable Care Expo – Dallas – Medical Auditing Solutions LLC August 1 2012

As many of you know the Patient Protection Accountable Care Act has a mandate requiring the implementation of cost containment managed care of patients, or Accountable Care Organization (ACO).  Many have been sitting on the sidelines waiting for the US Supreme Court Ruling on, and since they upheld ObamaCare….this is moving forward.  So, join Dallas area providers as they collaborate on HOW IN THE HECK to implement programs locally and make it work.  Providers and patients need to take a valid interest in being proactive versus treating the present situation.  You can view the agenda and register for the Dallas Accountable Care Expo to be held August 1, 2012 all day attendance is free except for the luncheon.  If you are not in the Dallas area, there are ACO Expos planned for Chicago and Las Vegas with others in the works.

Angela Miller, President of Medical Auditing Solutions LLC will be speaking on the Compliance Program Requirement.  All participants in an ACO must have a compliance program in place to participate so before March 2013.  Ms. Miller has over 18 years experience in corporate compliance programs, healthcare billing, collections, and coding audits.

Edward Vishnevetsky, Healthcare attorney with Munsch Hardt will be the luncheon Keynote Speaker on “Obstacles with ACO.”  Have you ever been able to listen to an attorney for the cost of lunch?  Well, mark this on your calendar and register now.  Mr. Vishnevetsky will also be speaking on the implications of the US Supreme Court Decision to uphold ObamaCare.

Bring your questions, concerns, and ideas on August 1, 2012.  It will be a day of speakers and exhibitor booths.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller is Certified in Healthcare Compliance.  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.

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PRESS RELEASE: KYMESA Announces Partnership with Medical Auditing Solutions LLC

Medical Auditing Solutions LLC (“MAS”) is excited to announce its partnership with Kentucky Medical Equipment Suppliers Association (“KYMESA”).   KYMESA has selected MAS to be their preferred vendor for Healthcare Compliance, HIPAA,  and Billing Analysis Programs.

Angela Miller is the founding owner of MAS a company specializing in Healthcare compliance & HIPAA privacy program development and training, billing analysis, and cash flow management.  Ms. Miller spent 12 years in HME starting here in Kentucky where she grew up and her family continues to reside.  She prior experience  as a compliance officer where she managed a very proactive successful program for 5 years.

MAS just released MAS Compliance University which has 4 e-learning programs currently with 3 more to be uploaded for compliance and HIPAA privacy training.  These programs have a pretest, required one hour program, required test and evaluation all of which are tracked and can be exported to excel for client records.  MAS also provides billing compliance audits which not only keeps you in compliance with the coverage criteria but will help improve the overall efficiency of the business processes as she understands the importance of running lean with the reimbursement cuts and competitive bidding on the table.

Don’t forget a formal compliance program is required to be in place by 2013.  If you are not doing annual HIPAA privacy training and don’t have security policies, this is required.

You may contact Kentucky Medical Equipment Suppliers Association about their membership benefits and how they work on the state and federal level:

KYMESA

#394, 1303 US 127 S

Suite 402

Frankfort, KY 40601
Cell (407) 435-2667
Fax (502) 416-0328

Teresa Camfield, Director

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.

Compliance Program Development Required by 2013

Have you started developing your compliance program yet?  Do you have a compliance program that is incomplete or not as active as it should be?

The Health Care Reform Act and the Patient Protection and Affordable Care Act require a compliance program be implemented by 2013 for all health care providers and dental providers that bill Medicare and Medicaid or any federal and state funded programs. The OIG (Office of Inspector General) has had suggested compliance program guidance for several years for hospital, physicians, DME and home health. I would recommend health care providers start planning by using these OIG guidelines because it will take at least 9 months to have a program implemented completely. A compliance program will also help your business run more efficiently if the program is managed correctly.

Compliance programs focuses business operations & management, contracts, relationships, billing, and the laws associated with each. Two key components to ensure success for the program is executive support and employee participation.   A compliance program  is more than policies.

The elements of a compliance program include:

1. Compliance Officer, which may hold several positions in smaller agencies.

2. Compliance Committee, best to have managers or supervisors from various departments to be a solid advisory committee.

3. Standard of Conduct covers various topics from Stark Law, Antikickback statute, Company funds, Investigations & legal matters, billing expectations, complaint reporting, and much more.

4. Policies and Procedures expand some sections of the standards of conduct such as the billing section.

5. Training of at least 5 hours per year, in addition to the training for privacy and security annually.

6. Auditing and Monitoring help ensure the risk areas for the company and identified by the OIG stay within the regulations and coverage criteria, prevents fraud and abuse or at least early detection, and training to prevent the repeat of erroneous actions.

7. Hotline for reporting,even if it is a local phone number for small companies with 1 to 2 locations. Complaint reporting should not be limited to a hotline.  Complaints should be allowed by email, mail, and fax as well. You need a hotline poster, but it does not have to be elaborate or expensive.

If you can you help with your compliance program, we have extensive experience in health care compliance program development and management.

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.

Medtrade Fall 2010 – Got Your KX? Get Cash $$

I will be speaking at Medtrade Fall 2010, November 18 at 8:30am-9:30am.  Learn the misconceptions of filing with the KX Modifier.  Also learn what you must have in your file for medical necessity documentation to submit a claim with the KX Modifier.  With so many audit contractors (RAC, ZPIC, payor, OIG) going after the DME industry and KX modifier products, it is critical that you attend and hear proactive measures to protect your business.

Universal Software Solutions is sponsoring my presentation.  I greatly appreciate their support and sponsorship.

You will be able to find Universal and myself at booth 335.  I will be speaking at their booth on November 17 at 11am and 3pm as well as November 18 at 10am.  All topics will be billing and collections related.

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.

Medtrade-Atlanta Want to Shake Your Hand

Medtrade will be here in just a few short weeks.  I would like to meet the health care providers attending.  I am taking appointments now.  This is a tough time for health care providers and I would like to take the opportunity to shake your hand and pat you on the back for all your hard work to make a difference in this industry.

I speak on Thursday, November 18, 8:30am on Got Your KX? Get Cash.  This is a may audit issue.  We will discuss how to safe guard your business.  You can still register to attend now at Medtrade.

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.

15 Minute Thoughts: NP and PA Visits: Can the non-physician provider be billed under the physician?

Reminder for our call TODAY Wednesday

Program your Phone and Calendar:

Date & Time:                                        August 11, 2010,   8:30am-8:45am CST

MAS Conference Call Dial-in#:     218-862-1300

Conference Code:                               622911

MAS Office number:                          972-459-1508

Who should call in?

Any health care provider, Health care business owner or manager, Attorneys, Compliance Officer, Physicians, Non-physician providers, and Office Managers

Topic

NP & PA Visits: Can the non-physician provider be billed under the physician? I  have heard many questions in the last few months about whether a NP, PA, CNS can be billed under the physician’s provider number for any reason.  Can it be done while the non-physician provider is waiting on their only provider number?

Join myself and guest speaker, Edward Vishnevetsky as he provides input on whether non-physician providers can be billed under the physician provider number.  Mr. Vishnevesky is with Thompson & Coe in the Dallas, Texas office.  Edward L. Vishnevetsky has extensive experience in the area of health law and commercial litigation. He routinely argues before state and federal courts in areas of health law, employment law, and complex commercial litigation, and also represents hospitals, physicians, durable medical equipment (DME) providers and manufacturers before various state and federal regulatory agencies. Edward advises health care clients on operational matters, liability exposure, privacy issues, federal and state health care regulatory compliance, health care reimbursement disputes, as well as risk management issues. Edward is fluent in Russian and has conversational knowledge of Spanish.  To read his complete & extensive biography visit Thompson & Coe or Edward Vishnevetsky.

Join the next discussion in one week:

August 18, 2010         Payer Audits Giving “RAC’d” a Whole New Meaning: Tips to Manage Audits

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.

Bankruptcy Attorneys & other Attorneys: What you need to know about Medical Receivables 7/14/2010

“15 MINUTE THOUGHT”

***REMINDER***

What you Need to Know about Medical Receivables

MAS is pioneering an informational program that you can listen to over a cup of coffee while you organize your day or on your drive to work. The name of the program is “15 Minute Thought”.  These calls will be free and informative.  Our focus is to give you a new thought once per month to help improve your business during these tough regulatory times.  The call participation should be maintained although CME/CEUs are not attached, it documentation of education efforts.

We will discuss key points that you need to know when managing a corporate bankruptcy.  Your goal is to collect as much of the receivables as possible to pay off creditors.  One very very critical thing is, insurance payers do not wait for the court system.  Tune in so we can help you improve your collection rates.

Program your Phone and Calendar:

The 2^nd* and 3^rd Wednesday Every Month                July 14, 2010  at 8:30am-8:45am CST

Speaker:                                                Angela Miller, CHC & Compliance & Billing Expert

MAS Conference Call Dial-in#:     218-862-1300

Conference Code:                               622911

MAS Office number:                          972-459-1508

Who should call in?

All Attorneys and specifically Bankruptcy Attorneys

Follow MAS Blog for Schedule & Updates.  You can “follow” MAS on all social media and new blog links are published.  We only publish useful information and breaking news.

Blog:  http://www.angelamillermas.wordpress.com or via website
Linkedin:  http://www.linkedin.com/in/medicalauditingsolutions
Facebook:  http://www.facebook.com/home.php#!/AngelaMiller.MAS

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.

“15 Minute Thought” Schedule – Free Informational Programs

“15 MINUTE THOUGHT”

MAS is pioneering an informational program that you can listen to over a cup of coffee while you organize your day or on your drive to work. The name of the program is “15 Minute Thought”.  These calls will be free and informative.  Our focus is to give you a new thought once per month to help improve your business during these tough regulatory times.

Program your Phone and Calendar:

The 2^nd* and 3^rd Wednesday Every Month                 at 8:30am-8:45am CST

* Indicates specific audience

MAS Conference Call Dial-in#:         218-862-1300

Conference Code:                               622911

MAS Office number:                          972-459-1508

MAS Fax:                                               214-461-0295

Who should call in?

Any health care provider, Health care business owner or manager, Attorneys, Compliance Officer, and Office Managers

Schedule & Topics

July 14, 2010               Bankruptcy Attorneys & other Attorneys:  What you need to know about Medical Receivables*

July 21, 2010               Patient Visits: Changes, Increase Revenue, & Ordered Services

August 11, 2010         Physicians: NP & PA Visits: Can the non-physician provider be billed under the physician?*

August 18, 2010         Payer Audits Giving “RAC’d” a Whole New Meaning: Tips to Manage Audits

September 8, 2010      Conflict of Interest: Pay Attention or Write a Big Check

September 15, 2010    Compliance Officer:  Who? What? …Really?

October 13, 2010        Dental Providers:  Reform & Common Audit Errors*

October 20, 2010        Reserve Chute: Not just for jumping out of planes

There will be guest speakers.  We will release the brief description of the call within the next 24 hours.  There are plans to have Edward Vishnevetsky of Thompson Coe, Darrell Armer of Looper Reed & McGraw, David Reimer of Dental Medical Economics as well as others guest such as Advocate, MD present over the next few months as we roll this program out.  You will hear thoughts from some of the best in the health care industry.  The guest schedules are not finalized and they may participate in programs setup on this schedule.  We may increase the number of calls depending on the attendance.

Follow MAS Blog for Schedule & Updates.  You can “follow” MAS on all social media and new blog links are published.  We only publish useful information and breaking news.

Blog:  http://www.angelamillermas.wordpress.com or via website
Linkedin:  http://www.linkedin.com/in/medicalauditingsolutions
Facebook:  http://www.facebook.com/home.php#!/AngelaMiller.MAS

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.  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.

Numerous Physician, Physician Groups, and DME Revocations Coming

The American Health Lawyers listserv released yesterday, there are numerous revocations across physician, physician groups, and DME providers for failure to respond to 855 validation or update requests or the provider was not open or available during a sight visit.  Please ensure you or your staff open mail in a timely manner!  Be sure you take immediate action on any requests from Medicare.  Medicare periodically requests for updates, validation or new 855 payor applications be completed. If the Medicare contractor does a sight visit, you must have hours posted and the door must be unlocked and the person greeted, if it is during your business hours.   Likewise, if you are closed for vacation, post a sign on the door & answering service vacation dates and who patients should see in an emergency.  This may have come as a PECOS notice.  Think of PECOS as your online 855 submission and application management.  Educate your staff to review mail timely and notify you immediately of any requests from Medicare for any response, forms, documentation.  You as the business owner need to review it or have it reviewed.

It seems every time  we turn around there is bad news to deliver to health care providers.  This is a very scary time from audits, revocations, reimbursement cuts along with legible documentation and getting patients to come into the office for an in-person visit when they are physically not capable.  The industry is facing challenges.

Medicare must be notified if you move because they mail requests to the address on file.  Remember, an invalid telephone number or area code can result in revocation as well.  Likewise, the post office does not always deliver the mail and they do not send communication with a tracking number!

You have 30 days to submit a corrective action plan, but be proactive and do it immediately!  The Corrective Action Plan form can be located via the MAC contractor website.  If the Correction Action Plan is denied, there is no appeal!

It is crucial for you to keep your provider number because without it you will not be reimbursed and are subject to loosing other payor contracts. You have to get your number placed in good standing, but this can be a long process.  They also do not have to activate it back to the date it was turned off.  If you need help completing or validating the 855 application or working an appeal, we can help you in a cost effective manner.   We work with several health care law firms that can assist you also.  Be sure no matter who you have help you, they have experience with the application process, understand the health care industry and/or are health care attorneys.

I feel like I need to have a drink or joke of the week blog so I can bring some good uplifting news.

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.  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.

Medicare Timely Filing Reduced to 12 Months

As you may recall in my earlier health reform blog,  I noted that one of the several changes to be implemented was the reduction of the initial claims filing period reduced from 18 months to 12 months.  I would encourage you to read the other operational changes impacting collections noted in the blog.

Region A MAC and HCCA Compliance Weekly published the system change on May 14.  Each contractor may have a different published date but it appears that the announcements will be coming very shortly.

Note the change is RETROACTIVE to all claims on or after January 1, 2010! This would indicate that CMS has most likely directed all contractors to this announcement.  Notify your billing staff ASAP, they only have 1 year to file an initial claim.  For providers who must receive documentation from physician’s prior to billing, you must be more diligent than ever before.  If the physician’s are not providing the necessary information to bill for the services ordered, get the patient involved.  The patient can request a copy of their record at any time and can carry the order to the physician for signature.

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.  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.