Healthicity Blog

It’s been almost a year and many compliance officers are still trying to figure out how to make use of the OIG Resource Guide.

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.