The Department for Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) have the responsibility to make sure that the funds are properly protected. To this end, they have contractors who audit charts to prevent fraud and abuse. Among them are the Zone Program Integrity Contractors (ZPICS), who audit Medicare A and B, hospice home health, and durable medical equipment programs.
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As the ICD-10 deadline looms closer and closer to the October 1, 2014 implementation date, it is important that every provider and his or her staff learn the rules pertaining to the ICD-10 codes.
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It is hard to believe that the deadline for mandatory implementation for ICD-10 is less than one year away. On October 1, 2014, the United States will implement the World Health Organization’s (WHO) mandate for the clinical modification of diseases and morbidity classification. This is known as ICD-10-CM
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The recent changes in health care have prompted talk of doctors choosing to opt out of the Medicare program. Is this a viable option for you as a chiropractor? Ignorance of the law is no excuse as they say.
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On September 7, 2013, National Government Services (NGS) took over the contract as a carrier for processing claims and adjudication of Medicare in Illinois, Wisconsin, and Minnesota. Wisconsin Physician Services (WPS) was our former carrier for as long as I can remember. It is just a change in carriers, right? After all, it is still Medicare. Or is it?
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The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was implemented in four different phases to ensure compliance. The latest portion of HIPAA is the SECURITY RULE, which went into effect on April 21, 2005. All providers, except for small health plans, should have been in compliance by April 20, 2005. The exception for small health plans mandates that they must be compliant no later than April 20 of 2006.
Read More![New 1500 Health Insurance Claim Form Released [Updated]](https://ilchiro.org/wp-content/uploads/2019/06/claim-form_fJ4yIBD_-627x376.jpg)
The National Uniform Claim Committee (NUCC) announced on February 15, 2013, the implementation of the newest version of the health insurance claim form, which is to be denoted as 02/12.
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Recently the U.S. Department of Health and Human Services, Office of Inspector General released a new publication booklet, “Avoiding Medicare and Medicaid Fraud and Abuse.”In its publication, the Government agencies (Department of Justice, the Department of Health and Human Services, Office of Inspector General, and the Centers for Medicare and Medicaid Services) outlined five of the most important federal laws affecting physicians’ offices. The Office of Inspector General recommends that physicians frequently conduct self-audits. In an effort to help with your recommended self-audits, I have provided a synopsis of the five most prevalent federal laws affecting our offices:
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