This session was recorded on Friday, January 10, 2013.
The opportunity arose to have Bill Malm deliver a hugely popular webinar, normally reserved for only Craneware’s clients.
Bill is available THIS week, so THIS week it was.
The handout alone is worth having – 108 SLIDES. But YOU can hear Bill explain it all – and if you think he’s great talking about auditing, wait til you hear him on THIS subject…
LUCKY US and LUCKY YOU!
The most interesting exchange is at 44:00 in…
“Scope Creep” in Appeals is Dead CMS has instructed MACs and QICs to limit their review to the reason(s) the claim or line item at issue was initially denied. For redeterminations and reconsiderations of claims denied following a complex prepayment review, a complex post-payment review, or an automated post-payment review by a contractor, Limiting the scope of review on redeterminations and reconsiderations of certain claims. MLN Matters Number SE1521.
CMS should focus its billing audits less on verifying medical necessity and more on rooting out blatant fraud, the agency’s likely next secretary said Tuesday. Rep. Tom Price, R-Ga.
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