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Tag Archives: MAC

Navigating the UPIC Investigation from a Compliance Consultant’s Perspective

Compliance, Toni ElhomsBy NAMASMay 20, 2022

  May 20, 2022 | By Toni Elhoms, CCS, CPC, CPMA, CRC Over the past year and a half, I have seen a significant increase in the volume of Unified Program Integrity Contractor (UPIC) investigations taking place in private physician practices.  UPICs work on behalf of CMS to perform program integrity functions like detecting fraud,…

The Telehealth Conundrum – MAC vs National CMS Guidance

E/M Coding & Auditing, Holly CassanoBy NAMASJune 26, 2020

June 26, 2020 | By Holly Cassano, CPC, CRC As we move through the COVID-19 pandemic, many of us in health care are finding that many opinions and much guidance exists on the topic of telehealth/telemedicine, from many various sources. At the beginning of the COVID-19 public health emergency, the rules literally seemed to change…

That is How We Have Always Done It

Compliance, Procedural Coding & Auditing, Stephanie AllardBy NAMASMay 1, 2020

    May 1, 2020 | By Stephanie Allard, CPC, CEMA, RHIT Over the years I have found that one of the main risks to an organization are employees who get comfortable in their positions to the point where the explanation for or response to an audit variance is “that is how we have always…

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