Newsworthy
User Rating:  / 2

When it comes to medical billing, integrity is key.  Physicians count on us to properly code and bill out claims to insurance companies for reimbursement; if we dont do our job, not only would we generate a bad name for ourselves, but also any physicians that we are affliated with.  Here at Advanced Billing Consultants, Inc., we pride ourselves in having employees that are honest and conscientious medical billers.  Our Passion Is Your Sucess; Choose Advanced Billing Consultants for your physician's medical billing services!

Below is an article from The United States Department of Justice about a unscrupulous medical billing management company, JJ&R:

 FOR IMMEDIATE RELEASE

Thursday, September 1, 2011
California Medical Billing Company Agrees to Pay U.S. $4.6 Million to Resolve Allegations of False Claims to Federal Health Care Programs

 

WASHINGTON – Janzen, Johnston & Rockwell Emergency Medicine Management Services Inc. (JJ&R), a provider of billing services for physicians, hospitals and other health care providers, has agreed to pay the United States $4.6 million to settle allegations that it submitted false claims to Medicare and Louisiana’s Medicaid program, the Justice Department announced today. JJ&R is headquartered in El Segundo, Calif.

 

Today’s settlement resolves allegations that JJ&R inflated claims that it had coded on behalf of emergency room physicians in Louisiana and California. From approximately 2000 through 2007, JJ&R utilized a coding formula that had a tendency to generate claims for a marginally higher level of evaluation and management service than the physicians had actually provided. In addition, JJ&R routinely added charges to the evaluation and management claim for minor services, such as pulse oximetry, that had been provided by hospital nursing staff or other physicians.

 

Finally, during this time period, JJ&R often failed to comply with Medicare’s coding rules governing the submission of claims for teaching physicians, resulting in the submission of claims that were not properly payable. While these coding practices had a relatively small impact on the reimbursement of any particular claim, over time they generated significant overpayments from Medicare and Medicaid.

“Inflating individual health care claims by even small amounts can cause significant losses to Medicare and Medicaid,” said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. “Taxpayers should not be on the hook for charges that shouldn’t have been added or claims that shouldn’t have been submitted.”

 

“In Louisiana’s Middle District we are committed to using all available tools, including affirmative civil actions, to combat health care fraud,” said Donald J. Cazayoux Jr., U.S. Attorney for the Middle District of Alabama.

“The Office of the Inspector General recognizes and appreciates the importance of whistleblowers in the fight against health care fraud,” said William W. Root, Assistant Special Agent-in-Charge for the U.S. Department of Health and

Human Services (HHS).

 

Today’s settlement resolves allegations that were the subject of a federal investigation and a lawsuit brought by Le Jeanne Harris, a former employee of JJ&R. The lawsuit was filed under the False Claims Act, which enables private persons to sue on behalf of the United States, and to receive a share of any recovery. In this case, Ms. Harris will receive $774,450.

This matter was handled by the U.S. Attorney’s Office for the Middle District of Louisiana, as well as HHS Office of the Inspector General (OIG) and the Commercial Litigation Branch - Fraud Section of the Justice Department’s Civil Division. HHS-OIG investigated the matter.

This resolution is part of the government’s emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of HHS, in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover more than $5.9 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 are more than $7.5 billion.

User Rating:  / 1

CompuGroup Medical

Alteer Office® 8.0

Certification Facts™

ONC-ATCB 2011/2012 - EHR Technology for Eligible Providers

This Complete EHR is 2011/2012 compliant and has been certified by an ONC-ATCB in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments.

Additional information is available at ONC’s Certified HIT Products List (CHPL).

  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  
  • Meets  

The following information was provided by the organization applying for certification of this product.

About Alteer Office

Alteer Office 8.0, a fully integrated SaaS-based (Software as a Service) Integrated EHR and PM solution is 2011/2012 compliant and is certified as a "Complete EHR" by the Certification Commission for Health Information Technology (CCHIT®), an ONC-ATCB, in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. Alteer Office is backed by more than 15 years of experience, providing the features, functionality and ease of use necessary for physicians to quickly become skillful in their use while minimizing disruption to their current workflow. Alteer Office 8.0 focuses on strengthening the product's ability to report on patient outcomes and clinical quality as well as exchanging data with outside sources.

Clinical Benefits
• Various features compute toward percentage calculation for the Automate Measures reporting requirements
• Automate measure calculation computes the meaningful use objective with a percentage-based measure, pulling information from data entered
• Plot and display growth charts
• Maintain active/inactive medication allergy list
• Compare and reconcile medication list
• Drug/Drug, Drug/Allergy, Drug/Diagnosis Interactions
• Drug formulary checks
• Maintain up-to-date problem list
• Clinical decision support
• Incorporate lab results
• Computerized provider order entry
• Patient specific educational resources
• Enable patients timely online access to their clinical information
• Generate patient reminders
• Generate patient lists

Interoperability Benefits
• Submission to immunization registries
• Record, modify, retrieve and submit syndromic-based public health surveillance information
• ePrescribe
• Exchange Clinical Information and Patient Summary Record
• Provide electronic copy of health information
• Provide Clinical Summaries
• Calculate and submit Clinical Quality Measures

Security Benefits
• Access control
• Authentication
• Automatic log-off
• Emergency access
• Accounting of disclosures
• Audit log

About CompuGroup Medical

CompuGroup Medical US

CompuGroup Medical US is a subsidiary of CompuGroup Medical, AG – one of the leading eHealth companies in the world. CompuGroup Medical US works to synchronize the systems of the healthcare industry with the mission of patient care, enabling providers to achieve the best possible outcomes for their patients. CompuGroup Medical US creates healthcare IT solutions to support the clinical and practice management activities that take place in physician practices, community health centers and hospitals. These solutions including Meaningful Use and 2011 CCHIT Certified® electronic health records (EHRs) that are proven to contribute to safer, higher quality and more efficient healthcare. We also provide practice management (PM) software and productivity tools, EDI/reimbursement, lab information systems and more. With locations in 20 countries and customers in 34 countries worldwide, the CompuGroup Medical companies provide software and services to a customer base of doctors, dentists, hospitals, pharmacies, networks, and other service providers. For more information about CompuGroup Medical US, visit http://www.CGMus.com

  This email address is being protected from spambots. You need JavaScript enabled to view it.  

(877) 891-8777

User Rating:  / 0

Advanced Billing Consultants, Inc. is proud to share with everyone that we are now moved into our new location!  The new address is 30021 Tomas, Suite 250, Rancho Santa Margarita, Ca 92688.  Please update your contact information.

30021 tomas rsm 92688

User Rating:  / 0

In a continued effort to protect the privacy and security of TRICARE's 9.6 million beneficiaries, starting June 1, 2011, the Department of Defense (DoD) will no longer issue military ID cards with an individual's Social Security Number (SSN) as an identifier.

SSNs will be removed from ID cards and the DoD will issue new cards as individuals enlist or as a card expires. It is anticipated that there will be a four year transition time to issue all new cards.

SSNs will be replaced by two new numbers:

  • DoD Identification Number (DoD EDI-PI or DoD ID): This unique 10-digit number is assigned to every person with a direct relationship with the DoD (as determined by having a record in the Defense Enrollment Eligibility Reporting System [DEERS]). This number already exists and is commonly known as the Electronic Data Interchange Person Identifier (EDI-PI).
  • DoD Benefits Number (DBN): This 11-digit number will be used to determine benefits eligibility. The first nine digits are common to the sponsor; the last two digits identify the specific person, much like with a commercial benefit plan. The number can be found above the bar code on the back of the beneficiary's ID card.

Read more...

User Rating:  / 0

As we embark upon 2011, the necessity to improve the efficiency and profitability of our Medical Billing has never been more important. In the face of rising practice costs coupled with declining or stagnant reimbursement, the challenges presented to medical professionals and their billers will be daunting. Many billing operations have not kept up with the ever-changing challenges and the risks to their practices, and this will become very apparent in the New Year. Here are some suggestions to assist your medical billers and some deadly pitfalls to avoid.

Read more...