Visit the ACR website at www.rheumatology.org/practice to locate the necessary guidelines on key documentation and coding. For additional questions or information on coding and audit presentations in your area, contact Melesia Tillman, CPC-I, CRHC, CHA, coding and reimbursement specialist for the ACR, at [email protected] or (404) 633-3777, ext. 820.
Related Articles
Understanding & Preparing for Payer Audits
Audit activity among Medicare and most third-party payers has increased in response to pressure to reduce healthcare costs. The return of billions of dollars to Medicare, Medicaid and third-party programs through these medical audit reviews has also increased. For example, the Government Accountability Office (GAO) 2014 Annual Report estimated that the Centers for Medicare &…
Rheumatology Practice Pearls: Appealing an Audit
The appeals process for a Medicare or Recovery Audit Contractor audit is a multistep process with filing deadlines attached to each level.
Medicare Bills Under the Magnifying Glass
What you need to know about the Recovery Audit Contractor program
Different Payer Audits Require Different Preparation & Response
For a provider of healthcare services, payer audits are always a possibility. Both government and private payers consistently monitor providers to prevent fraud, overpayment, and improper billing or coding procedures. Audits can be nerve-racking and intimidating, even if a provider is billing correctly. Improper billing can lead to civil and criminal sanctions. To alleviate some…