be used to identify risk areas. as a result, this may also be a good time to compare your clients’ billing trends over a designated period of time to assist with the identification of potential areas of concern. for example, sharp increases in the number of higher level e/m codes billed would be a good item to evaluate. any analysis that you could conduct would help identify what payors are already evaluating. continual improvement of the practice’s coding and claim submission processes helps ensure proper reimbursement for services performed. be a good partner to your clients. While it might initially create some uncomfortable conversations, in the long run it is better than the conversations that could arise between their attorney and the entities that might be auditing their services. Melody W. Mulaik, MSHS is the President and Co-Founder of Coding Strategies, Inc. and Coding Metrix, Inc. located in Atlanta, GA. She is a frequent speaker and author for CSI and other nationally recognized professional organizations and publications. Melody's areas of expertise include billing and collections, coding and compliance, revenue enhancement, front-end hospital operations, management engineering, medical school relations and operations improvement. Resources 1 https://oig.hhs.gov/oei/reports/oei-04-10-00180.pdf 2 http://www.publicintegrity.org/2012/09/15/10810/ how-doctors-and-hospitals-have-collected-billionsquestionable medicare-fees 3 http://www.washingtonpost.com/national/health-science/ doctors-others-billing-medicare-at-higher-rates/ 2012/ 09/15/27047458-f2fa-11e1-adc6- 87dfa8eff430_story.html 4 http://www.ama-assn.org/amednews/2012/07/09/ bisc0709.htm 5 http://www.connolly.com/healthcare/pages/ approvedissues.aspx 6 http://www.publicintegrity.org/2012/09/15/10810/howdoctors and-hospitals-have-collected-billions-questionablemedicare fees 7 http://www.washingtonpost.com/national/healthscience/ doctors-others-billing-medicare-at-higherrates/ 2012/09/15/27047458-f2fa-11e1-adc6-87dfa8eff4 30_story.html BE A PART OF HBMA’s 20th ANNIVERSARY CELEBRATION AND MAKE SOME MEMORIES! NATIONAL CONFERENCE CAESARS PALACE • LAS VEGAS, NV SEPTEMBER 18-20 the journal of the healthcare billing and management association 45
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