Mario P. Fucinari DC, CPCO, CPPM, CIC, Author at Illinois Chiropractic Society

Avoiding Medicare and Medicaid Fraud and Abuse

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Oct 1, 2012 | Insurance, Medicare and Medicaid, zall | 0 |

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:

Comparative Billing Report (CBR)?

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Feb 1, 2011 | Billing and Collections, Insurance, zall | 0 |

Recently, many chiropractors throughout the nation received their Comparative Billing Report (CBR). In an attempt to educate top utilization providers, the Zone Program Integrity Contractors provided those specific providers with a CBR. Whether or not you received a CBR, you should be aware of the findings of the report.

Avoiding a Medicare Audit

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Aug 1, 2010 | Insurance, Medicare and Medicaid, zall | 0 |

In the new healthcare bill, Patient Protection and Affordable Care Act (Public Law 111-148) signed into law by President Obama, one of the many changes to our industry includes the requirement found under “Enrollment Requirements under Medicare, Medicaid and CHIP:

Medicare Medical Necessity

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jan 1, 2010 | Medicare and Medicaid, zall | 0 |

Medicare has three criteria that must be met to prove medical necessity.

Future of Chiropractic

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Aug 1, 2009 | Compliance, zall | 0 |

We have always had an uphill battle, fighting against medical and pharmaceutical foes. The tide has shifted with the prevention of illness and disease as a necessary method of extending our lifespan.

Proving Medical Necessity (Part 1)

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jul 1, 2009 | Medicare and Medicaid, zall | 0 |

The best way to prove medical necessity in order to improve reimbursement and decrease the likelihood of being audited. is through detailed documentation.

National Provider Identifier (NPI) Required for ALL Providers

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Nov 1, 2006 | HIPAA, zall | 0 |

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated that the Secretary of Health and Human Services adopt a standard unique health identifier for health care providers. On January 23, 2004, the Secretary published a Final Rule that adopted the National Provider Identifier (NPI) as this identifier.