GOV’T AUDIT INSIDER: Very good compliance in New York
Healthcare Auditing Weekly, December 21, 2004
Senior Blue Health Plan, a division of the health benefits firm HealthNow New York, Inc., complied with federal prompt payment regulations for claims submitted by noncontracted providers and paid more than 95% of clean claims within 30 days of receipt, says an OIG audit report. However, HealthNow did not pay or deny some claims within 60 days of receipt because its claims-processing system did not differentiate claims submitted by its enrollees from routine correspondence. The OIG recommends that HealthNow ensure that all claims are paid or denied within 60 days of receipt. During the audit, the OIG did the following:
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- HIPAA Q&A: Flu shot requirement for hospital employees
- Running an effective peer review committee meeting
- HealthDataInsights posts new issues for medical necessity claims
- Sneak Peek: Effort underway to establish caseload benchmarks
- Q/A: Coding for telescopic intraocular lens
- New FAQ posted on storing laryngoscope blades
- Tip: Perform your own internal investigation prior to government audit
- HIPAA 5010 deadline extended, but threat remains, says AMA
- HHS task force: Consider privacy, security with text messages
- What does case-mix index mean to you?
- E-mailed
-
- Running an effective peer review committee meeting
- HIPAA Q&A: Flu shot requirement for hospital employees
- HHS task force: Consider privacy, security with text messages
- What does case-mix index mean to you?
- Q/A: Coding for telescopic intraocular lens
- Q/A: Correct use of modifier -PT
- Tip: Correctly code bilateral pain management procedures
- "Wall fountains" may be spreading Legionnaires to patients, visitors
- 2012 CPT code changes for ASCs: Shoulder and knee scopes and pain management
- COT basics to best
- Searched