August 20, 2021 | By J. Paul Spencer, CPC, COC In my role as a compliance consultant specializing in carrier audit response, a lot of items are brought to my attention on a daily basis, with the bearer of said items asking questions such as, “What’s this?” and “Do I have to respond to…
July 2, 2021 | By Pam Brooks, MHA, COC, CPC As an auditor, you might find that the “meat and potatoes” of the audit is the most interesting part. Then you finish and it is time to pull together your findings into an executive summary. The best and most effective executive summary design is…
January 19, 2020 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Welcome to 2020! It is my hope that all of you had a great holiday season and New Year and are well-rested and ready to take on the challenges of this new year head-on and armed with the necessary…
January 24, 2020 | By Frank Cohen, Director of Analytics and Busines Intelligence The first thing to note is that I am not an auditor. So, for me to write an article on auditing tips might seem a bit out of place. But this is not an article on auditing compliance but rather…
December 18, 2020 | By Paul Spencer, CPC, COC “Risk adjustment,” as defined by CMS, is a method by which Medicare Advantage plans are compensated for demonstrating that the Medicare patients they cover under Part C plans are sicker than those covered under traditional Medicare or other plans. Increasingly, when I speak to practices,…