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Unnecessary Diagnostic Tests Cost Doctors Millions in False Claims Settlements

Posted by CJ Wolf, Sep 9, 2021 10:32:50 AM

Typically, when you feel sick, injured, or uncertain about a health condition you’re experiencing, you go to a doctor. 

Compliance News Roundup: Medical Necessity is a Necessity

Posted by Healthicity, Sep 11, 2019 10:38:34 AM

1. Billing Company Owner Sentenced to Prison for Fraud -

STOP! Listen to THIS Podcast Before Auditing Medical Necessity and MDM

Posted by CJ Wolf, Mar 21, 2019 9:52:18 AM

In this episode of Compliance Conversations, I chatted with Charla Prillaman, the Regional Vice President for Healthicity Audit Services and 30-year audit veteran

How to Correctly Code TCM Services: Everything You've Ever Wanted to Know

Posted by Elizabeth Wright, Aug 15, 2017 10:58:17 AM

Sometimes, when I mention coding and documenting Transitional Care Management, coders and auditors will get a crazy look in their eye that can best be described as, “subtle fear.”

But don’t panic, it’s easier than you think!

Deeper Than the Headlines: Compliance Lessons From the NYC Regional Compliance Conference

Posted by CJ Wolf, Jun 5, 2017 9:00:00 AM

It’s always interesting to hear a doctor’s perspective on compliance, but it’s even more interesting when that doctor happens to be the OIG’s Chief Medical Officer. I had the pleasure of hearing her, Julie Taitsman, MD, JD, speak at the HCCA’s Regional Compliance Conference this May in New York City.

Deeper Than the Headlines: Doctors Blowing the Whistle on Other Doctors

Posted by CJ Wolf, Feb 6, 2017 9:00:00 AM

In December of 2016, the U.S. Attorney’s Office for the Southern District of Florida announced a $12 million settlement with South Miami Hospital regarding allegations of medically unnecessary cardiac electrophysiology studies and other procedures allegedly performed by John R. Dylewski, M.D.

Get 1 CEU And Learn Crucial 99211 Tips And Tricks

Posted by Elizabeth Wright, Jan 31, 2017 11:05:50 AM

Great News: Due to popular demand you'll have the option to purchase 1 CEU for our upcoming webinar. And, as always, you can also attend this webinar free of charge. Now, let’s talk about 99211.

Auditing When There Are Conflicts of Interest

Posted by Lamon Willis, Jul 19, 2016 1:44:33 PM

Healthcare environments are prone to conflicts of interest. Healthcare is the perfect example of a complex adaptive system (CAS).These systems are prone to error on a regular basis, but, lucky for us, they’re also capable of incredible innovation, if the right conditions are created.