Medicare, Cures for Billing Code Complexity: Hearing Before the Subcommittee on Human Resources of the Committee on Government Reform and Oversight, House of Representatives, One Hundred Fifth Congress, Second Session, April 9, 1998U.S. Government Printing Office, 1998 - 241 pages |
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Page 13
... Medicare claims billing . And if found to be wrong , the hospital will have a significant penalty to pay despite its best efforts to comply with Medicare's rules and regulations . THE PROBLEM EXACERBATED Until 1994 , government agencies ...
... Medicare claims billing . And if found to be wrong , the hospital will have a significant penalty to pay despite its best efforts to comply with Medicare's rules and regulations . THE PROBLEM EXACERBATED Until 1994 , government agencies ...
Page 33
... Medicare's co - payment deductible on a case by case basis , without the accusation of fraud . 13. Physicians must continue to cooperate with and oversee the medical necessity of DME , hospice and home health . 14. Joint principles by ...
... Medicare's co - payment deductible on a case by case basis , without the accusation of fraud . 13. Physicians must continue to cooperate with and oversee the medical necessity of DME , hospice and home health . 14. Joint principles by ...
Page 73
... Medicare rules , we purchase compliance primers to help us address regulatory issues which are constantly changing , and we ... Medicare's list . This wastes valuable time and creates the uncomfortable situation of changing the original ...
... Medicare rules , we purchase compliance primers to help us address regulatory issues which are constantly changing , and we ... Medicare's list . This wastes valuable time and creates the uncomfortable situation of changing the original ...
Page 75
... Medicare does not take the time to educate the patient that the Medicare program does not cover screening tests , what constitutes screening under Medicare's interpretation , and that only certain diagnoses linked to a test will be ...
... Medicare does not take the time to educate the patient that the Medicare program does not cover screening tests , what constitutes screening under Medicare's interpretation , and that only certain diagnoses linked to a test will be ...
Page 102
... Medicare program presents a sizeable target to those who seek to unjustly enrich themselves at the taxpayers ' expense ... Medicare's eligibility requirements ; ( 3 ) the contractor had not made duplicate payments or payments for which ...
... Medicare program presents a sizeable target to those who seek to unjustly enrich themselves at the taxpayers ' expense ... Medicare's eligibility requirements ; ( 3 ) the contractor had not made duplicate payments or payments for which ...
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Common terms and phrases
administrative American Medical Association April 9 audit BARRETT billion Blue Cross Blue Shield BUIE chart clinical Code Complexity CONGRE CONGRESS THE LIBRARY contractor COOLEY coverage policies CPT codes criminal Cross and Blue diagnosis diagnosis code DICKEY doctors documentation guidelines E/M services E&M codes evaluation and management exam False Claims Act federal fraud and abuse fund going HCFA hearing hospital investigation issue Kansas City KOPF LEITCH level of E/M LIBRARY OF CONGRESS look management codes medical records medical review medical savings accounts Medical Society Medicare beneficiaries Medicare billing Medicare carrier Medicare patients Medicare program Medicare's medicine medigap nurse office visit panel payment penalties percent physicians practice price controls problem procedures question RBRVS Reform and Oversight regulations reimbursement Rheumatology ROBERTSON ROSENBERG SNOWBARGER specialty staff Subcommittee on Human Thank TILGHMAN Vance Vince Snowbarger
Popular passages
Page 202 - Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided...
Page 6 - I ask further unanimous consent that all witnesses be permitted to include their written statements in the record; and without objection, so ordered.
Page 55 - When counseling and/or coordination of care dominates (more than 50%) the physician/patient and/or family encounter (face-to-face time in the office or other outpatient setting or floor/unit time in the hospital or nursing facility), then time may be considered the key or controlling factor to qualify for a particular level of E/M services.
Page 50 - Other relevant social factors System Review (Review of Systems) An inventory of body systems obtained through a series of questions seeking to identify signs and/or symptoms that the patient may be experiencing or has experienced.
Page 205 - The Office of the Inspector General (OIG) of the Department of Health and Human Services has undertaken a study to assess these concerns.
Page 48 - A chief complaint is a concise statement describing the symptom, problem, condition, diagnosis, or other factor that is the reason for the encounter, usually stated in the patient's words.
Page 157 - For purposes of this section, the terms "knowing" and "knowingly" mean that a person, with respect to information — (1) has actual knowledge of the information; (2) acts in deliberate ignorance of the truth or falsity of the information; or (3) acts in reckless disregard of the truth or falsity of the information, and no proof of specific intent to defraud is required. (c) Claim defined. For purposes of this section, "claim...
Page 55 - ... the amount and/or complexity of medical records, diagnostic tests, and/or other information that must be obtained, reviewed, and analyzed, •od • the risk of significant complications, morbidity and/or mortality, as well as comorbidiues.
Page 1 - Mr. SHAYS. I would like to call this hearing to order and to welcome our very distinguished witnesses and our guests, as well.
Page 63 - System/Body Area Elements of Examination Constitutional Measurement of any three of the following seven vital signs: 1) sitting or standing blood pressure, 2) supine blood pressure, 3) pulse rate and regularity, 4) respiration, 5) temperature, 6) height, 7) weight (May be measured and recorded by ancillary staff) General appearance of patient (eg, development, nutrition, body habitus, deformities, attention to grooming...