The Coding Compliance Podcast

Independent reviews of a revenue cycle are crucial to ensuring the financial health of your organization.  Whether its looking at your organization’s processes to identify charge capture opportunities, validating coding accuracy, or maintaining compliance with the Department of Justice’s guidelines for compliance plans, independent reviews serve to provide senior leadership with clarity as to the efficiency and success of their rev...

CMS’s Targeted Probe and Educate (“TPE”) Program is yet another mechanism to ensure accurate and compliant claims are submitted for reimbursement to Medicare.  This episode Teresa Mason of Epstein Becker Green joins the team to delve into what do TPE’s consist of, how to best handle them and which steps can be taken ahead of time to avoid being targeted for a TPE audit.  Tune in to make sure you are prepared ...

While outsourcing functions of the revenue cycle, often times it can feel convenient and synergistic to have one entity perform both the billing and coding functions.  But buyer beware, there are pitfalls to taking this approach.  The Coding Compliance Podcast Team explores what to look out for and consider when outsourcing billing and coding helping you avoid unforeseen deficiencies and ensuring you make the...

While auditing coding and documentation is critical to validating your compliance efforts, once you have results that fall short of your established accuracy threshold, remediation is the next step in the process. Figuring out who is subject to remediation, what that consists of and how to validate whether your measures worked are key elements to creating an effective response to deficient coding and documentation....

Selecting the right auditing team is critical to getting the feedback your organization needs to improve on any outstanding deficiencies.  This holds true whether you’re performing internal or external audits to validate your organization’s coding and documentation efforts.  The Coding Compliance Podcast lays out some of the key factors to bear in mind when picking your auditors and setting up an audit schedule to help you get the ...

Crafting a coding compliance plan hinges on setting clear timelines and standards for validating your organization’s coding efforts.  Determining how providers and coders must perform, when the veracity of their documentation and code assignment should be reviewed, the methodology for auditing their cases, and what to do if they fail to meet organizational standards are some of the key components for developing and implementing a p...