What will auditors find if your claims or documentation were to be audited? What would be the results be if you were investigated?
Blue Cross, Aetna and Medicare have increased audits. Recovery Audit Contractors are paid 24% commission to search through your records and recover funds for Medicare. What will you do when they audit you?
In July of 2019, Jim was one of 50 compliance officers chosen from over 500 applicants from around the nation to be selected to participated in a two day Compliance Symposium sponsored by the FBI and the Society of Corporate Compliance and Ethics. The symposium was held at the FBI Headquarters in Washington D.C. and…Read More
Compliance is required in health care and other industries. Based on information gathered, the OIG in 2018, determined that 41% of all chiropractic claims had errors or were deemed fraudulent. It is for these reasons the OIG has targeted the chiropractic field and has made it part of their work plan each year since. Many…Read More
Any doctor or entity receiving reimbursement from a federally funded health care program such as Medicare, Medicaid, Tri-Care, etc. is required to have compliance program based on Seven (7) Elements as described in the Federal Sentencing Guidelines. The 7 Elements are; Assign a designated Compliance Officer. Have open lines of communication to the Compliance Officer.…Read More
The Office of Civil Rights requires entities to have a properly developed HIPAA Compliance Program which is focused on protecting the privacy of patients and their Protected Healthcare Information. Some of the requirements of a HIPAA Compliance Program are; Designate the following Compliance Officers Privacy Security Complaint Compliance Conduct a Security Risk Analysis of practice…Read More
To be OIG and HIPAA compliant it is more than just purchasing a manual or having a consultant come to the office to conduct a compliance or chart audit. In this article published in ChiroEconomics, we discuss the importance of selecting a certified and knowledgeable compliance consultant. The consultant should assist you in making your practice…Read More
Facing the Men in Black What would you do if you saw “men in black” identifying themselves as FBI agents standing in the middle of your waiting room? Panic? Freak out? Faint? Many doctors think they are “flying under the radar,” but the truth may surprise you! Check out this article published in Chiropractic Economics.…Read More
You can be ‘Honest Abe’ and still fall short of the ‘Lincoln Law’ Do you realize what you are attesting to when you submit a claim? Box 31 of the 1500 claim form reads: “Signature of physician or supplier including degrees or credentials (I certify that the statements on the reverse apply to the bill…Read More
We offer complete solutions & specialized programs
Complete Office Compliance Audits
Complete Physical Office Audit inspecting for Medicare/OIG, HIPAA, OSHA, NCQA, CLIA and ADA requirements and guideline compliance.
Patient File Review Audits
Charts are audited for proper documentation requirements, billing, coding, and medical necessity of services.
conduct training for your office staff and employees on a variety of topics including Medicare/OIG and HIPAA compliance as well as billing, coding, and documentation.
Compliance Officer Services
We will help guide you and oversee your compliance efforts to ensure that you are compliant in the requirements and guidelines.