10 Factors that Could Trigger an Audit of Your Medical Records

With the ever-increasing litigious environment and mandatory Congressional oversight of commercial and government payers, physician supporting documentation should emphasize and include the type of service(s) provided, the time involved, special technology and equipment used, as well as any other complications encountered.Furthermore, because the government and insurance carriers routinely perform audits as mandated through the Fraud, Waste and Abuse program, it’s important for providers to be aware of problems that could cause them to come under…

Will Your Late Entry Process Withstand an Integrity Audit?

In recent months, LW Consulting, Inc. (LWCI) has been assisting clients with responding to Safeguard Unified Program Integrity Contractors (UPICs) and Medicare Administrative Contractors (MACs). During this process, LWCI has observed an increase in denials purely based on delayed or late entries within the documentation submitted for review to the UPICs and MACs. Over the next few weeks, LWCI will be reviewing the Centers for Medicare & Medicaid Services’ (CMS) signature requirements and late entries…