Competitive Bidding – Credit Report before January 30, 2012

Posted on January 23, 2012 by

For Round 2 of Competitive Bidding, your credit report must be dated prior to bid opening of January 30, 2012. The credit report cannot be more than 90 days old either.

You may use Experian, Equifax, TransUnion, Standard & Poors or Dun & Bradstreet. Posted By John Allman (Reposted for)

Please share.  Don’t miss a deadline so simple that could exclude you from participating!

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.


Posted in 2, allman, Angela, Auditing, bid, competitive, Competitive Bid, credit, DME & Pharmacy, Health Care & Medical, john, medical, Miller, report, round, Solutions | Leave a comment

OIG Work Plan 2012

Posted on January 23, 2012 by

I participated in a call on Thursday January 19, 2012, on the OIG Work Plan for 2012.  Please reference the link for the full OIG Work Plan spelled out by provider type.  Many items on the Work Plan never change but there were a few points I felt important to draw your attention to for risk management purposes.  Here are a few notes I made because I think the audit risk is high since the result can be subjective:

1.  Outpatient Observation Billing

2.  Critical Access Hospitals:

A.  Distance to nearest, non-critical access hospital

B.  Herceptin and other Chemo Drug quantity

3.  Hospice because 82% of patients do not meet criteria to be admitted to hospice.

4.  Incident to Services by non-qualified personnel.  Even Blue Cross and Blue Shield is recouping and extrapolating on commercial claims for mid-level practitioner billing.  Make sure modifier is used when appropriate and the mid-level meets the licensing requirements to provide the services billed.

5.  Off Label Prescriptions.  Physicians ordering a drug that is approved for Diagnosis A but the drug is used for diagnosis B.

6.  Home Health-but not specific because they are going to review 2010 billing before they decide.

7.  Dialysis and ESRD Drug costs.  What is the drug cost to the provider versus the reimbursement.

8.  Contracts providers have with other providers/facilities.  Make sure you have a health care attorney to review the contract before executing because the health care attorneys are familiar with the Stark and Anti-Kickback provisions which typically the corporate business attorney does not have to consider.

9.  Checking employees, vendors, and providers against Sanction Databases MONTHLY.  You may find the federal links on my website.  The states have their own links.

10.  NY Medicaid reduced the annual revenues to $500K in Medicaid/Medicaid HMO/Managed Care Organizations (MCO) funds for compliance program requirement.

11.  Compliance Program Requirement under Federal Deficit Reduction Act that required all healthcare providers to have a compliance program in place by 2007 if their annual collected revenue of State reimbursement was $5M or more.  This would include Medicaid and respective Medicaid HMO or MCO.

12.  As of 2013 a healthcare compliance program is required for all providers billing Federal or State plans no matter what the annual billing revenue may be.  This would include dental practices because they bill Medicaid!

13.  Overpayments must be disclosed and refunded within 60 days of identification that it is an overpayment.  Failure to refund this money can result in “False Claims” charges and penalties.  Ensure you have someone that is accountable for working your credit balance reports monthly.  Keep documentation of these reviews and refunds issued as a result in a manner that can easily be explained and found.

The OIG Work Plan can be used to determine risk analysis, structure audit plans, and determine growth opportunities.

Do you have a Healthcare Compliance Program?

Do you review the OIG Work Plan Annually?

What else do you review to determine your audit plan?

We can help you analyze the status of your healthcare compliance program and ensure you have focused on the correct risks for your business model.  We are the compliance expert with a vast history and a cost effective way to ensure your compliance program is operating and managing your risk.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.


Posted in 2012, access, All Healthcare Providers, Angela, audit, Auditing, chemo, claims, compliance, Compliance & HIPAA Information, Compliance Program Development, contract, critical, database, Dentists, DME & Pharmacy, drugs, excluded, exclusion, false, health, Health Care & Medical, healthcare, home, home health, incident to, Miller, OIG, overpayment, physician, Physicians, plan, program, provider, risk, Solutions, Work | Leave a comment

Hello world!

Posted on December 13, 2011 by

Welcome to WordPress. This is your first post. Edit or delete it, then start blogging!

Posted in Uncategorized | Leave a comment

PRESS RELEASE: KYMESA Announces Partnership with Medical Auditing Solutions LLC

Posted on December 3, 2011 by

Medical Auditing Solutions LLC (“MAS”) is excited to announce its partnership with Kentucky Medical Equipment Suppliers Association (“KYMESA”).   KYMESA has selected MAS to be their preferred vendor for Healthcare Compliance, HIPAA,  and Billing Analysis Programs.

Angela Miller is the founding owner of MAS a company specializing in Healthcare compliance & HIPAA privacy program development and training, billing analysis, and cash flow management.  Ms. Miller spent 12 years in HME starting here in Kentucky where she grew up and her family continues to reside.  She prior experience  as a compliance officer where she managed a very proactive successful program for 5 years.

MAS just released MAS Compliance University which has 4 e-learning programs currently with 3 more to be uploaded for compliance and HIPAA privacy training.  These programs have a pretest, required one hour program, required test and evaluation all of which are tracked and can be exported to excel for client records.  MAS also provides billing compliance audits which not only keeps you in compliance with the coverage criteria but will help improve the overall efficiency of the business processes as she understands the importance of running lean with the reimbursement cuts and competitive bidding on the table.

Don’t forget a formal compliance program is required to be in place by 2013.  If you are not doing annual HIPAA privacy training and don’t have security policies, this is required.

You may contact Kentucky Medical Equipment Suppliers Association about their membership benefits and how they work on the state and federal level:

#394, 1303 US 127 S

Suite 402

Frankfort, KY 40601
Cell (407) 435-2667
Fax (502) 416-0328

Teresa Camfield, Director

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.


Posted in analysis, Angela, association, Auditing, billing, Billing & Collections, compliance, Compliance & HIPAA Information, Compliance Program Development, DME & Pharmacy, equipment, Health Care & Medical, HITECH HIPAA, kentucky, kymesa, medical, Miller, preferred, program, Solutions, suppliers, vendor | Comments Off

Innovation & Cost Savings: Beacon by LabCorp

Posted on October 17, 2011 by

I recently attended a meeting and LabCorp Representative spoke about various services they offer.  Toni Spain is very knowledgeable and passionate about patient care and provider the tools to the physicians to be more efficient, cost effective for the provider and provide the best care to the patient.

Ms. Spain introduced Beacon, which is at no additional cost to a general LabCorp account!  Beacon is virtual access to lab results and providers up to 2 years of lab history for the patient, no matter who ordered previous tests on file.  This will save the payers money and provider the physicians the ability to make decisions and treatment recommendations quicker for better quality patient care.  The patients many times do not remember what kind of tests other physicians orders, the results, or which physician ordered it.

This is an innovative step for LabCorp right at the time when Medicare is trying to implement Accountable Care Organizations which is all about quality care for the least expense by managing medical costs.

Contact Toni Spain for more information on this product that will change your office.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.


Posted in 2, accountable, ACO, All Healthcare Providers, Angela, Auditing, beacon, care, costs, Dementia Care & Treatment, faster, Health Care & Medical, history, home health, labcorp, Lung Disease, managing, medical, Medicare, Miller, organizations, patient evaluation visits, Physicians, quality, results, Solutions, spain, test, toni, two, year | Comments Off

Caring for a Baby-boomer? A New Panel to Discuss Topics to Help you through the Maze

Posted on September 30, 2011 by

As busy professionals, there are many roles we have signed up for, and some we have not. One of the roles many of us have assumed is as care taker of our parents. There is even a new term to describe our new role, the sandwich generation.

On October 4th, D.R. Saur will host a panel discussion to shed light on the many facets of building a comprehensive strategy to fulfill that role. We will have legal, financial, and insurance experts to answer your questions. We still have a few seats available for both the 9:00 and 12:00 noon sessions. A light meal will be served as well for your convenience.

Seating is limited, so if you and/or your parent would like to join us, please contact Stephanie at DR Saur at 214 559 3944 to reserve your spot. Please see the attached invitation for all the details.

Posted on behalf of Kelly Kunst. One of the most fantastic ladies and perfect to be one of the speakers and head up this panel. She is an expert in financial services, but her passion is educating people on the tough topics.


Posted in attorney, baby-boomer, Beneficiary, caretaker, DR, elder, financial, generation, Health Care & Medical, insurance, Insurance Applications, Kelly, Kunst, panel, parent caretaker, parents, sandwich, Saur | Comments Off

PRESS RELEASE: Compliance University Rollout

Posted on September 9, 2011 by

September 9, 2011

Medical Auditing Solutions LLC is excited to announce the release of our new service called “Compliance University.”  The Compliance University focuses on the healthcare regulatory compliance annual training requirements for all employees.  HIPAA requires annual privacy and security training for all employees (2003 & 2010) respectively.  Compliance (billing, contracts, and relationships) is required as part of the Healthcare Reform Act and the Patient Protection Accountability and Affordable Care Act due 2013.  This training is only one aspect of an effect Compliance program.  Privacy and Security is primarily monitored, audited and investigated by HHS and Office of Civil Rights.  Compliance is primarily monitored, audited, and investigated by CMS, OIG, HHS, FBI.  The monitoring, auditing, and investigation may start in other federal and state government areas.

All programs are general in nature and meant for any type of health care providers.  They are between 40 minutes and 1 hour.  Each program is followed by a test of comprehension, an evaluation that is required to receive the completion certificate.  The Compliance University will provide the company with status, completion, grade reports.  We have additional programs to be released within the next few weeks as well to complete the set.  The programs contain examples and explanation for various health care industries so the knowledge obtained can be applied in any setting.

We look forward to helping you with your compliance program training as well as other areas of development and tracking that you may need to complete.  Check out our website at www.MedicalAuditingSolutions.com and Compliance University.  Mention this press release “PRESS” and receive 10% discount.

FBI-Federal Bureau of Investigation

HHS-Health and Human Services

OCR-Office of Civil Rights

OIG-Office of Inspector General

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.


Posted in All Healthcare Providers, Angela, annual, Auditing, compliance, Compliance Program Development, Dentists, DME & Pharmacy, employee, Health Care & Medical, healthcare, HITECH HIPAA, home health, Lung Disease, medical, Miller, Physicians, program, regulatory, security, Solutions, Staff, training | Comments Off

Compliance Program Development Required by 2013

Posted on August 6, 2011 by

Have you started developing your compliance program yet?  Do you have a compliance program that is incomplete or not as active as it should be?

The Health Care Reform Act and the Patient Protection and Affordable Care Act require a compliance program be implemented by 2013 for all health care providers and dental providers that bill Medicare and Medicaid or any federal and state funded programs. The OIG (Office of Inspector General) has had suggested compliance program guidance for several years for hospital, physicians, DME and home health. I would recommend health care providers start planning by using these OIG guidelines because it will take at least 9 months to have a program implemented completely. A compliance program will also help your business run more efficiently if the program is managed correctly.
Compliance programs focuses business operations & management, contracts, relationships, billing, and the laws associated with each. Two key components to ensure success for the program is executive support and employee participation.   A compliance program  is more than policies.
The elements of a compliance program include:
1. Compliance Officer, which may hold several positions in smaller agencies.
2. Compliance Committee, best to have managers or supervisors from various departments to be a solid advisory committee.
3. Standard of Conduct covers various topics from Stark Law, Antikickback statute, Company funds, Investigations & legal matters, billing expectations, complaint reporting, and much more.
4. Policies and Procedures expand some sections of the standards of conduct such as the billing section.
5. Training of at least 5 hours per year, in addition to the training for privacy and security annually.
6. Auditing and Monitoring help ensure the risk areas for the company and identified by the OIG stay within the regulations and coverage criteria, prevents fraud and abuse or at least early detection, and training to prevent the repeat of erroneous actions.
7. Hotline for reporting,even if it is a local phone number for small companies with 1 to 2 locations. Complaint reporting should not be limited to a hotline.  Complaints should be allowed by email, mail, and fax as well. You need a hotline poster, but it does not have to be elaborate or expensive.
If you can you help with your compliance program, we have extensive experience in health care compliance program development and management.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.


Posted in All Healthcare Providers, Angela, Auditing, billing, committee, compliance, Compliance & HIPAA Information, Compliance Program Development, conduct, Dentists, DME & Pharmacy, Health Care & Medical, home health, hotline, medical, Miller, officer, operations, Physicians, policies, procedures, program, provider, providers, Solutions, standards, training | Comments Off

Star 10R Training: Identify Dementia Signs Early & Even Prevent Dementia

Posted on May 25, 2011 by

Star 10R Training Seminar for Caregivers

We know the sacrifice that Caregivers make for their loved ones. Our organization looks for resources to help providers and caregivers  care for your loved ones. We have met with AFFECTS a Texas based entity that is well known for Innovation, Creativity and Entrepreneurship, and definitely not a traditional company by any means.

We hope you are excited!  Mr. Ray Ashton who is the Founder of this highly progressive company out of Houston is very passionate about his innovative training.  This life long mission was sparked because his grandmother passed away after years of suffering from Dementia.  Read more about Mr. Ashton.  He actually coined the term,  “Preventive Wellness” about 22 years ago.  His healthcare company, STAR Preventive Wellness (AFFECTS LLC), is training the Healthcare professional across the country with main focus on Geriatric and Early Stage Dementia, in particular.  His idea is to train the Communities’ own staff (or individuals) including RN’s, LVN’s and just about anyone who works with Seniors including Case Managers, Administrators or Social Workers. His 8-Hour CEU training is really a must for anyone who works at Memory Care, Assisted Living or Skilled Nursing communities.

They have 2 meetings planned this summer:
Hosuton Class Information
Dementia Education Houston, Texas

One is being planned for the Dallas metroplex for July, with details TBA soon.  A convenient location for those attending is being sought since this is a large metroplex, price and program length will remain the same.  Please contact Star10R  at star-10r-dallas@affects.biz or star@affects.biz  for interest in the Dallas or Houston areas.

 His main goal is to get this knowledge out there. On that note, he has made his programs’ cost close to nothing. He only charges $350 per individual or only $3000 a community to train 10 Cargivers ($300 per community caregiver). Please let me know if you can make this training and feel free to pass this along. This training is also a great marketing tool for communities to differentiate themselves, while reducing cost with no overhead or risks for that matter.  Remember, this does provide 8 CEUs for this class if you attend the entire day.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.


Posted in 10R, All Healthcare Providers, Angela, ashton, Auditing, care, caregivers, CEU, dementia, Dementia Care & Treatment, family, health, Health Care & Medical, home health, innovative, medical, Miller, nurses, Physicians, providers, ray, Solutions, star, treatment | Comments Off

Lung Disease Management Conference

Posted on May 24, 2011 by

It is my pleasure to announce the 2 day course June 22-23, in fabulous Las Vegas, offered by Lung Center University.  If you are a health care provider that cares for patients with Lung Disease, you will not want to miss this conference.  Learn about the changes made in 2010 to Pulmonary Rehabilitation guidelines.  This program showcases the latest therapies and treatment options for patients suffering from chronic lung disorders.  You will learn how to manage costs better, improve quality of care, and grow your disease management program.  This was created for skilled nursing facilities, home health, and outpatient facilities to discuss hospital to home solutions for these chronically ill patients.

Read more and register at  Lung Center University  Please contact Lung Center University direct for any questions and information.

Speakers include Greg Shockey, President of America, Mel Arenas, RT & Sr. VP of Lung Centers of America, Jim Girard is the National Sales Manager for Schiller-America and Jan Jennings, President & CEO of American Healthcare Solutions.  This team of speakers has a very well documented and prestigious career in the health care industry.  You can read the extensive biography on each speaker under the agenda.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria through compliance program development, management and training.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.


Posted in All Healthcare Providers, Angela, arenas, Auditing, center, disease, DME & Pharmacy, girard, greg, health, Health Care & Medical, home, home health, hospital, jan, jennings, jim, lung, Lung Disease, management, medical, mel, Miller, nursing, Physicians, rehab, Schiller-America, shockey, skilled, Solutions, university | Comments Off