Prepayment Review

Home Health Prepayment Reviews are Increasing. Is Your Documentation Compliant?

Home Health & Hospice /

(January 30, 2013): Are the home health services you are currently providing compliant with applicable coverage, documentation and medical necessity requirements? Have you carefully reviewed your current caseload to ensure that each patient does, in fact, qualify as “homebound.” Do you have an effective Compliance Plan in place to assist you with your efforts? Now, […]

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Options for Responding if Your Practice is Placed on ZPIC Prepayment Review

Medicare, Medicaid & Private Payor Updates /

(September 3, 2012): Zone Program Integrity Contractors (ZPICs) have turned much of their attention to prepayment review, the process by which the Medicare contractor reviews a claim for problems before it is paid. Unlike postpayment review, ZPIC prepayment review does not have an administrative appeals process, making these types of reviews incredibly damaging for a

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Georgia Prepayment Reviews are Being Conducted by AdvanceMed

Medicare, Medicaid & Private Payor Updates /

(February 29, 2012): In the past few weeks, AdvanceMed Corporation, the Zone Program Integrity Contractor (ZPIC) for Regions II and V (covering the Northwestern and Southeastern portions of the United States, respectively), appears to have significantly expanded the number of Georgia prepayment reviews it is conducting. More specifically, AdvanceMed appears to be focusing on hospices,

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RAC-Initiated Medicare Prepayment Reviews Will Soon Begin.

Medicare, Medicaid & Private Payor Updates /

(February 7, 2012): In recent years, physicians and other health care providers have faced a wide number of administrative actions and sanctions levied by contractors working for the Centers for Medicare and Medicaid Services (CMS). Zone Program Integrity Contractors (ZPICs) have subjected physician practices to Medicare prepayment reviews, postpayment audits, suspension and / or revocation

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