What Can I Expect With a MediCorp Compliance and Oversight Plan?

Our Full Service Plans are designed to provide compliance oversight and consulting for established practices with single or multiple locations and multiple providers of any combination of disciplines.

Services Include:

  • Scheduled audits with written reports with optional follow-up conference call
  • Unlimited telephone/email assistance on any matter
  • Practice Expansion and Change of Scope Consultations
  • E-mailed MediCorp Alerts on CMS and other carrier coverage issues including changes in coding and documentation requirements
  • Coding changes (CPT and ICD-10), including our annual analysis of the new codes
  • Heads up notices on pending legislation and regulations
  • Professional employee pre-screening checks as well as ongoing monthly reports through OIG Exclusion monitoring
  • Claim denial review with correction advice
  • Carrier intervention on unjust practices and denials
  • Pre-purchase product evaluation and telephone consultation
  • EMR integration consultation
  • Webinar training

 

Other Options:

For Attorneys (Professional relationship as consulting experts)

  • Client compliance review, written report of findings on coding, utilization, documentation and adherence to regulations.
  • Review of the carrier’s audit.
  • Research, review, preparation and consulting expert services.  

We work closely with our Attorney clients to assess their client’s current compliance, establish an effective compliance plan and provide ongoing oversight under the Attorney work product relationship.

 

Consulting

Our consulting services are as diverse as the issues you face in practice.

Consulting services are included in every MediCorp Compliance Solutions plan based on the nature and needs of the client. Unlike other “consultants” who charge up to $36,000 a year, we choose to tailor your solutions to your practice needs

As a client, you are welcome to call or e-mail with questions on proper coding, documentation standards, pre-purchase advice on new equipment or any other practice issue where you have concerns.

 

Oversight and Assistance

SURPRISING FACT: MediCorp has performed thousands of comprehensive compliance audits. 94% of those practices were found to be “At Risk” 

Fee for Service Medicine is a thing of the past.  Today’s environment is constantly subject to carrier audits, scrutiny of care for medical necessity of services and denial of payment under carrier coverage policies and peer review.   Carrier demands for recovery of payments and allegations of fraud or abusive false claims are now commonplace.

Large or small, practices can lose thousands in revenue simply because they do not bill the items correctly or fail to document encounter specific evidence that properly supports the services billed or the necessity of diagnostics or continued care.

Due to the active audit threat, overly cautious healthcare providers are hesitant to  bill for everything they provide. Others continue to over-code, miscode or bill for unbundled components of comprehensive codes.  Improper use of modifiers, up-coding of E&M services, improper total timed service billings and improper relationship billings are all common audit discoveries with “penalties” based on We believe you knew or SHOULD HAVE KNOWN“.