"Nationwide Healthcare Lawyers"
(January 18, 2013): Specialty dental practices around the country are receiving audit letters from “Zone Program Integrity Contractors” (ZPICs), contractors working for the Centers for Medicare and Medicaid Services (CMS). This latest audit focus by ZPICs is rather surprising in light of the fact that very few dental procedures qualify for Medicare coverage and payment. […]
(December 31, 2012): Over the last year, many dentists, orthodontists and oral surgeons around the country who participate in federal health care benefits programs such as Medicare and Medicaid have found themselves accused of a “credible allegation of fraud,” levied by federal / state investigators or agents contracted to audit dental providers on behalf of
(December 30, 2012): Generally speaking, from the standpoint of a dental practice, “Cloud Computing” involves the use of an offsite server to store and access medical records, maintain patient information and or practice business records (such as coding and billing information). Cloud Service Providers (CSP) offer various services to dental practices. In most instances, the
(August 16, 2012): Thinking of sending your medical coding and billing functions out of the country? You better think twice. While overseas outsourced billing is growing in popularity for medical office functions, this practice represents a unique and growing set of problems for both physician practices and 3rd party billers. And the news is just
Overseas Outsourced Billing and Coding – Compliance Risks Read More »
(August 2, 2012): Under the Affordable Care Act (ACA), which was recently upheld by the Supreme Court, the Secretary of the Department of Health and Human Services (currently Kathleen Sebelius) may require that all providers participating in federal health care programs implement an effective compliance plan. While regulations covering this issue have not yet been
There are Seven Compliance Plan Elements – Is Your Healthcare Company Compliant? Read More »
(April 25, 2012): Yesterday we discussed issues surrounding returning an identified dental overpayment to Medicaid or other payors. Below is a continuation of this discussion. Dentists, oral surgeons and their staffs may ask “What types of actions might constitute an “identified” dental overpayment?” That’s a fair question, especially since the Affordable Care Act does not
Returning a Medicaid Dental Overpayment: Part II Read More »
(April 24, 2012): While considerable attention has been paid to the Affordable Care Act (generally referred to as “Health Care Reform”) and its requirement that “identified overpayments” be promptly repaid to the government, it is important to keep in mind that this repayment obligation is not new – it has long been firmly in place.
What are a Dentist’s Medicaid Overpayment Obligations? Part I Read More »
(April 23, 2012): Texas dentists, orthodontists and oral surgeons are under considerable scrutiny by the government, and most practices don’t even realize it. This article examines several one of the current tools being used by the government to calculate the alleged amount of “damages” (improper claims) paid to dental providers by the State under Medicaid.
Texas Medicaid Dental Claims Are Under Audit Scrutiny Read More »
(April 18, 2012): To be fair, when most dentists and oral surgeons think of an effective Dental Compliance Plan, it wouldn’t be unreasonable for them to think that the primary risks facing a dental practice would be limited to: Violations of the rules and regulations enforced by the Occupational Safety and Health Administration (OSHA). Violations
Components of an Effective Dental Compliance Plan Read More »
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