June 8, 2020
2 Interesting OIG Reports: Auditing Telemedicine Services, Medicare Hospital Provider Compliance Audits
The OIG posted two new interesting Audit Reports.
The first was posted June 3, 2020 addresses the OIG’s role in Auditing Telemedicine Services. As I stated when the pandemic began, given the rate with which information was being released and revised, audits of these services would be a big deal. An audit of Telemedicine services in Texas show they were provided in accordance with state requirements. The summary report can be found here with the full report linked here.
The second report (posted May 22, 2020) deals with Medicare Hospital Provider Compliance Audits: The Ohio State University Hospital (A-05-18-00042). The Hospital complied with Medicare billing requirements for 98 of 145 inpatient and outpatient claims audited. On the basis of the sample results, OIG estimated that the Hospital received overpayments of at least $3.7 million for the audit period. These were due to human error and lack of controls to prevent incorrect coding. The summary report can be found here with the full report linked here.
What to do next…
- If you need help with an audit appeal or regulatory compliance concern, contact us at (800) 635-4040 or via email at [email protected].
- Read more about our: Total Compliance Solution
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Experienced compliance professionals. Our compliance services are structured by a chief compliance officer and supported by a team that includes physicians, attorneys and a team of experienced auditors. The team has many decades of combined experience helping protect the interests of physicians and the organizations they serve.
Quality of coders and auditors. Our US-based auditors receive ongoing training and support from our education division, NAMAS (National Alliance of Medical Auditing Specialists). All team members possess over 15 years of experience and hold both the Certified Professional Coder (CPC®) as well as the Certified Professional Medical Auditor (CPMA®) credentials.
Proprietary risk-assessment technology – our auditing team uses ComplianceRiskAnalyzer(CRA)®, a sophisticated analytics solution that assesses critical risk areas. It enables our auditors to precisely select encounters that pose the greatest risk of triggering an audit so that they can be reviewed and the risk can be mitigated.
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