Healthicity Blog

1. Former Chief Financial Officer of Rocky Boy Health Clinic Sentenced to Prison -

EXAMPLES OF MODIFIER 59 ERRORS

Your organization is losing money. The OIG HHS reported that nearly 42% of Medicare claims for E/M services are incorrectly coded resulting in $6.7 billion in overpayments.

Most coders are familiar with the general rule of New vs. Established Patient for professional billing.

A few weeks ago, we presented a webinar on the impact of the 60-day overpayment rule since its release two years ago. We had so many questions at the end of the webinar, we couldn’t get to all of them.

According to a recent post on Justice.gov, “A Detroit, Michigan-area doctor was sentenced to 72 months in prison today for his role in a $10.4 million conspiracy to defraud the Medicare program.”

1. Mental Health Center to Pay $4 Million under AG Settlement for Illegally Billing MassHealth for Unlicensed Patient Care –

There’s nothing more frustrating to a coder than spending a good part of their work day correcting common provider coding errors.

A little over a month ago, I blogged about the OIG guidance regarding compliance requirements and risks associated with grants.