A recent audit conducted by the Office of Inspector General (OIG) projected that hospitals received $47.8 million in net overpayments from January 2018 through July 2019 for Medicare Part A claims that did not meet national...Read More »
We do many queries for malnutrition and are looking for a better way to get this essential diagnosis into the medical record without a query. I understand that some organizations have the dietitian document it and the provider attest to the diagnosis. Is that acceptable practice? Our thought is...Read More »
The Health and Human Services (HHS) Office of Inspector General (OIG) has announced its plan to audit hospitals for severe malnutrition diagnosis codes on inpatient claims.
SCAN Health Plan received nearly $55 million in overpayments for 164 unvalidated HCCs out of a 1,577 sample for 2015, according to an Office of the Inspector General (OIG) audit. The audit looked to verify diagnosis codes for...Read More »
The Office of Inspector General (OIG) recently conducted an audit of Healthfirst Health Plan, Inc., focused on seven groups of high-risk diagnosis codes to determine whether the organization complied with federal...Read More »
