by Erik Consorsha | May 15, 2020 | Compliance, FWA, Medical Record Auditing, Payers
Retired OIG Special Agent and Advize’s Director of Litigation & FWA Support will be stepping in each week to examine current fraud trends from the lens of an investigator. Stay tuned for weekly insights, updates, and information on healthcare’s most expensive...
by Erik Consorsha | Feb 7, 2018 | Coding
Late last month, Dr. Brenda Fitzgerald, Director of the Centers for Disease Control and Prevention, announced her resignation in response to a Politico report exposing an unethical conflict of interest between Fitzgerald and the tobacco industry. The report reveals...
by Erik Consorsha | Jan 31, 2018 | Careers, Coding
Strategy is Key Becoming a Certified Professional Coder is no easy feat, and the exam administered by the American Academy of Professional Coders (AAPC) is a long, grueling assessment. Of course, the exam will present CPCs-to-be questions on CPT codes, Evaluation and...
by Erik Consorsha | Feb 16, 2016 | Medical Record Auditing
Medical necessity documentation, or lack of it, is one of the most common reasons for claim denials. For a service to be considered medically necessary, it must be reasonable and necessary to diagnosis or treat a patient’s medical condition. When submitting claims for...
by Erik Consorsha | Aug 25, 2015 | Medical Record Auditing
DRG validation is a tool that can be used to reduce risk, defend claims, and ensure the accuracy of the coded items. The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary, as coded and reported...
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