When you work in healthcare, you need to be sure that you are doing things the right way. Not only do you need to care for your patients in an appropriate and helpful manner, but you need to navigate the complex world of billing and coding on a daily basis. Even beyond that, cutting corners can make life tougher on you than it needs to be, as medical malpractice is more prevalent when you are not paying attention to your compliance.
At Medical Auditing Solutions, we understand the power that comes with quality compliance. From your first moment in the office to your last task of the day, you need to be sure that you are working in the right way. To find out more about our range of helpful services for medical professionals, reach out to our office today.
See Patients Online? Take The Right Steps
Telemedicine is the process of seeing a patient by video and audio. There are specific place of service codes and modifiers, some vary by payer. For instance, there are now modifiers for opioid treatment. If you are providing telehealth services across state lines, ensure you are licensed or registered in the state in which the patient resides. Each state has different requirements!
Likewise, ensure you comply with prescription requirements and limitations. Expect guideline changes to telemedicine in the coming months, which is what we have heard from Novitas and First Health on their webinars this month. We can help with telemedicine audits to ensure the correct modifiers and coding is being used.
Special Compliance For Pharmacy And DME Providers
When shipping supplies, medication, or other services that are billable, the shipping confirmation and the receipt of delivery need to be downloaded and saved in your records. The couriers only keep the shipping and delivery confirmation for 90-180 days depending on the courier. If these cannot be provided in a post payment audit, the payer may deny the claim and recoup the money for the date of service.
Documentation of continued need and benefit of durable medical equipment or disposable supplies is a must in clinical records. CPAP Compliance is at an all-time difficulty. Patients don’t want to go back to the doctor or don’t understand why after 3 years they need to go back to the provider for a face-to-face meeting and CPAP usage downloads.
This is pretty new; the payers are requiring more and more documentation to continue to pay for supplies. Diabetic supplies need the patient testing logs. CPAP need CPAP usage downloads from the machines with a minimum of 4 hours a night. This has become a fight with patients to help them understand, and it means more work on the DME staff to ensure this happens. These are just two examples, and providers need to ensure their practices are tightly manned to guarantee compliance and payment!
Discover Effective Compliance Solutions With MAS
For healthcare providers, it’s not just about results; you need to do things in the proper way at every point in your day. If it all seems too much for you to handle on your own, call Medical Auditing Solutions at (972) 459-1508 today!