Webinar on What is a Compliance Program 101!


Medical Auditing Solutions is providing a webinar in conjunction with The Cornerstone Insurance Group (Cornerstone) to discuss the Basic Compliance Program Requirements.  We will learn what a compliance program is, what laws require it, the elements of a compliance program, and how the program can be beneficial to the healthcare provide.

Any and all healthcare providers (medical and dental practices as well as ancillary providers such as DME, Home Health, Hospice, etc.) taking Medicare and Medicaid should attend.

No CEU credit is formally given, but you will be welcome to send the handout received post attendance to your accrediting agency and ask for credit.  Some will provide and the worse they can do is say no.

The Cornerstone Insurance Group (Cornerstone) in no way endorses the accuracy of the information being provided.  In registering for this program, you will release and hold Cornerstone harmless of any and all actions you take as a result of this call.  This call is basic information and is simply an avenue for you to educate yourself on compliance program requirements.  This call in no way provides legal advice or provider specific advice without adequate documentation to review.  This is informational purposes only.

Cornerstone providers Total HR management & products including benefits management, Total Insurance products, Wellness Management Services.  Read more about the services Cornerstone offers you may find services that could benefit your organization.  They are primarily in Missouri and surrounding states but do cover additional states.

Program Title:  Compliance Program Basics and Elements

Date:                     July 24, 2012

Time:                    11:30 am-12:30 am CST

Cost:                      Complimentary

Register:              https://cc.readytalk.com/r/yhypbz3hj2p

About more about the speaker and 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 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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Physicians: Added Revenue for Assessments like Depression, ADD, BiPolar


Several months ago I met a representative from AssessMD.  I have observed and asked many questions.  AssessMD is a computer software that collects answers to questionnaires for assessments many physicians are doing manually now and not being reimbursed because the assessment is not scored.  AssessMD has assessments to score depression, bipolar, ADD, Anxiety, OCD, ODD,  and others with more test coming.  The patient completes the assessment in a few minutes on the physician’s computer or tablet, and produces scored results for the physician in real time.  The physician can then bill for this assessment in addition to the Evaluation and Management Code (E&M) with the documentation provided by this computerized assessment.

Medicare is now requiring annually assessment for depression among the elderly patients.

This is reimbursed by most insurance companies except certain Medicaid.  The reimburse on average is about $60, which would go direct to the physician’s bottom-line because right now if it is handwritten assessment it is not reimbursed.

The physician has a 45 day trial period to test it in his practice.   If you are not reimbursed by the insurance company, there is no charge of the test to the provider.  As a note, AssessMd is not in a position to be a referral stream only a vendor.

This was initially marketed to limited physician practice types, but they have discovered that it is beneficial to many practice areas pain management, obstetrics/gynecology, elder care, and adolescents to name a few.

At the very least it is worth the time to investigate and discuss with your legal counsel to add revenue to the practice.  If you do not have healthcare counsel, click for a list of affordable healthcare attorneys to ensure this is the right model for your practice.

Contact LouAnn McNaughton  at  “214*538*1123”  or   “LouAnn@assessMD.com”

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.

Is Your Credit Card Terminal PCI HIPAA Compliant?


World Pay is a company that I have come across that has some really good educational information for clients and perspective clients on Payment Care Industry or PCI Compliance.  HIPAA extends to protect the financial information of clients.  It is important that you have policies regarding your PCI practices or accepting and processing credit card payments.  If your credit card processing company helping you?  Is your credit card terminal PCI Compliant, feel free to check the lists for WPVeriFone EOL Products and WPHypercom T7Plus End of Life that have reached”End of Life” or are no longer compliant.

A company can be out of PCI compliance in two ways 1) the terminal they use does not meet criteria and 2) through processes of gathering, transmitting and storing data.

Let me tell you what impressed me about World Pay.  They have a terminal that is end to end encrypted to protect financial data.  This company has a tremendous about of education materials on this topic. There fee of $14.99/month of PCI compliance includes 24/7 customer service, guidance to get your policies and procedures in place, a third party vendor to provide PCI Accreditation and Certification for that process only, and $30K of indemnity coverage when using their standard terminal or $100K indemnity coverage if your are using their end to end encrypted terminal, they help with negotiations with visa, master card, etc., if their is a breach.  Additional medical audit and HIPAA breach defense coverage may be obtained through Jim Patterson at Agape Insurance

It is important that you ensure your credit card processing machine and process is HIPAA compliant.  Educate yourself and make an informed decision.  I have included links to PCI websites for further explanation of PCI Compliance.

What will you need to have a free PCI Compliance review provided?

1.  Your Credit Card Statement; Does your statement say “non-validation of PCI” with a fee?

2.  Name/Model# of the Terminal(s) being used

3.  Do you have policies and procedures for use, storage and transmission?

4.  Mention this blog from Medical Auditing Solutions

How do you get this complimentary PCI Compliance Review?

Have the information above available and Contact Martin Anderson with World Pay at *martin.anderson@worldpay.us*

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.

Caring for a Baby-boomer? A New Panel to Discuss Topics to Help you through the Maze


As busy professionals, there are many roles we have signed up for, and some we have not. One of the roles many of us have assumed is as care taker of our parents. There is even a new term to describe our new role, the sandwich generation.

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.

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 2nd* and 3rd 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.

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.

Scope of Services for www.medicalauditingsolutions.com


We thought it would be helpful if in our first blog we explained our SCOPE OF SERVICES for the Medical Auditing Solutions LLC.  We work with all types of health care providers including Durable Medical Equipment, Respiratory Med Pharmacy, Sleep Labs, Home Health Agencies, Small Physician Practices and Hospital Systems.  Our clients revenues vary tremendously from $2M-well over $100M annually.  Our focus is to help you manage your business by giving your problem solving direction although we can perform the hands on work as well.

  • Compliance/HIPAA Audits
    • Review patient charts to ensure compliance with billing and regulatory requirements and exit with management to discuss any areas of weakness with a written report to follow
    • All improve collections and efficiency
  • Compliance Program Development and Training
    • We can review your existing program and provide updates
  • Due Diligence Audits
    • Review patient charts as above and provide general feedback on branch, personnel, location, etc.
    • See Compliance Audits
  • Investigations including audits, interviews, etc. in coordination with your attorney, if applicable
  • Medical Accounts Receivable Analysis for Improved Collections
    • Review a sample of writes for accuracy and potential recovery
  • Medical Accounts Receivable Aging claim filings and staff education
  • Regulatory Affairs Filings To Do Business (NPI, licensing, permits, DBA’s, Certificates of Authority, provider/supplier applications)
    • Handle all filings, follow-up and renewals
  • Assess Medical staff knowledge and positions
  • Assess overall location
  • Assist with Health Care Accreditation, HR, and Operations
  • Work with the business to improve overall efficiency and profits
  • Practice Management and Quality of Care Auditing
    • Other healthcare consulting as needed see website

Monthly Availability via a retainer at competitive rates customized for your needs and the time period needed.