CMS MACs Begin to Audit Again – DOS After 3/2020

According to a recent Centers for Medicare and Medicaid Services (CMS) MLN Connections, Medicare Administrative Contractors (MAC) are beginning to conduct post-payment medical reviews for dates of services (DOS) after March 2020.  After a pause in audits due to...

HCC Coding Audits . . . A Must!

The words “Hierarchical Condition Categories” or HCCs can conquer up some anxiety for HIM Coding, and Clinical Documentation Integrity (CDI) professionals, even for Revenue Cycle and Compliance leadership. Add to that, the word “audit” and we now have uneasiness and...

2021 OIG Work Plan: An Overview and Auditing Priorities

This blog will provide some key points on how you can incorporate the current Office of Inspector General (OIG) items and future items into your organization’s auditing and monitoring functions.  Paying attention to what the OIG for Health and Human Services (HHS)...