Recent analysis by the Comprehensive Error Rate Testing (CERT) initiative of physical therapy claims revealed that insufficient documentation contributed to improper payments issued to providers.
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Recent analysis by the Comprehensive Error Rate Testing (CERT) initiative of physical therapy claims revealed that insufficient documentation contributed to improper payments issued to providers. Recent results from the Comprehensive Error Rate Testing (CERT) Program revealed that the majority of improper payment for laboratory service result from insufficient documentation. This article summarizes important documentation recommendations from CMS. It’s that time of the year when qualifying providers enrolled with the NYS Medicaid Program must certify that they have a adopted, implemented and maintained an effective mandatory compliance program. The NYS Office of the Medicaid Inspector General (OMIG) is tasked with responsibility of overseeing that providers meet this requirement. The second alternative treatment center recently became operational in New Jersey under the state’s Compassionate Use Medical Marijuana Act. We review some of the legal requirements that impact participating physicians. Documenting each patient encounter not only benefits the patient but it is also good preventative medicine for the doctor against claims of professional negligence, failure to meet certain professional standards, and investigations by government agencies. The position taken by most licensing boards and law enforcement agencies is that if an item or service is not documented in a patient’s medical record “it didn’t happen.” Below we discuss the minimum documentation requirements imposed by New Jersey Medicaid on participating providers. The fact that physicians must prepare and maintain records is hardly news to anyone. It may have, however, been a while since a physician last reviewed the requirements for patient documentation in New Jersey that are imposed by the Board of Medical Examiners (BME). Many New York State healthcare providers have recently felt the heavy hand of the state enforcement agency as the Office of Medicaid Inspector General (OMIG) seeks to recoup payments paid out to providers in an effort to eliminate fraud, waste and abuse in the healthcare industry. At a recent presentation given by OMIG, the agency There is an increased focus on the dental community from the New York State Office of Medicaid Inspector General (OMIG). At an increasing rate, OMIG is conducting audits of dentists and dental specialists, putting additional burden on providers already taxed with other statutory, regulatory and malpractice concerns. |
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