ZPIC Audits What We’ve Learned from 2011 and other Audit Risks Webinar

Posted on February 3, 2012 by

Edward Vishnevetsky, healthcare attorney with Munsch Hardt has asked Angela Miller to join him as a guest speaker during his presentation next Thursday, February 9, noon-1pm CST.  Audits are inevitable at this point, so better be prepared and proactive for the audits that are coming.  Join us as we discuss ZPIC audits and other audits you can expect in 2012, such as HIPAA, OCR, Medicaid RAC, Commercial audit expansion. Also learn how best to prepare and prevent  adverse outcomes.

You are Invited to Join our Complimentary Medicare ZPIC Audit Webinar

Featuring Topics on:

Changes to Medicare ZPIC and RAC Audits
The Office of the Inspector General’s (OIG) take on Audits in 2012 based on the 2012 OIG Work Plan
Which HCPCS codes may be most vulnerable and subject to scrutiny
How DME suppliers can work with physicians, hospitals and manufacturers to assist in responding to audits
Tips on how to effectively respond to audits (based on lessons learned in 2011)
Other Audit Risk and Prevention

Presentation Given By:

Edward Vishnevetsky

Attorney at Munsch Hardt Kopf & Harr, P.C.

Featuring Guest Speaker:

Angela Miller

President of Medical Auditing Solutions LLC

Date: Thursday, February 9th, 2012

Time: 12:00-1:00 PM CST

Cost: Complimentary

To reserve your Webinar seat, please click here.

After registering you will receive a confirmation email containing information about joining the Webinar.

If you have any questions, please contact Ashley Thomas.

Edward Vishnevetsky has successful defends over 40 physicians, DME providers and HHAs against ZPIC, CERT, MAC and RAC Audits; achieved 100% success rate in removing providers from pre-payment audit.  Successfully defended over 100 providers through all stages of Medicare appeals, including the Administrative Law Judge (ALJ) level.  Read more at Munsch-Vishnevetsky

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, audits, compliance, Compliance Program Development, DME, DME & Pharmacy, edward, hardt, Health Care & Medical, healthcare, HIPAA, HME, home health, medicaid, medical, Medicare Audits, Miller, musch, OCR, physician, Physicians, privacy, RAC, Solutions, vishnevetsky, webinar, ZPIC | Leave a comment

ZPIC Audits What We’ve Learned from 2011 and other Audit Risks Webinar

Posted on February 3, 2012 by

Edward Vishnevetsky, healthcare attorney with Munsch Hardt has asked Angela Miller to join him as a guest speaker during his presentation next Thursday, February 9, noon-1pm CST.  Audits are inevitable at this point, so better be prepared and proactive for the audits that are coming.  Join us as we discuss ZPIC audits and other audits you can expect in 2012, such as HIPAA, OCR, Medicaid RAC, Commercial audit expansion. Also learn how best to prepare and prevent  adverse outcomes.

You are Invited to Join our Complimentary Medicare ZPIC Audit Webinar

Featuring Topics on:

Changes to Medicare ZPIC and RAC Audits
The Office of the Inspector General’s (OIG) take on Audits in 2012 based on the 2012 OIG Work Plan
Which HCPCS codes may be most vulnerable and subject to scrutiny
How DME suppliers can work with physicians, hospitals and manufacturers to assist in responding to audits
Tips on how to effectively respond to audits (based on lessons learned in 2011)
Other Audit Risk and Prevention

Presentation Given By:

Edward Vishnevetsky

Attorney at Munsch Hardt Kopf & Harr, P.C.

Featuring Guest Speaker:

Angela Miller

President of Medical Auditing Solutions LLC

Date: Thursday, February 9th, 2012

Time: 12:00-1:00 PM CST

Cost: Complimentary

To reserve your Webinar seat, please click here.

After registering you will receive a confirmation email containing information about joining the Webinar.

If you have any questions, please contact Ashley Thomas.

Edward Vishnevetsky has successful defends over 40 physicians, DME providers and HHAs against ZPIC, CERT, MAC and RAC Audits; achieved 100% success rate in removing providers from pre-payment audit.  Successfully defended over 100 providers through all stages of Medicare appeals, including the Administrative Law Judge (ALJ) level.  Read more at Munsch-Vishnevetsky

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, audits, compliance, Compliance Program Development, DME, DME & Pharmacy, edward, hardt, Health Care & Medical, healthcare, HIPAA, HME, home health, medicaid, medical, Medicare Audits, Miller, musch, OCR, physician, Physicians, privacy, RAC, Solutions, vishnevetsky, webinar, ZPIC | Leave a comment

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 on PRESS RELEASE: KYMESA Announces Partnership with Medical Auditing Solutions LLC

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 on Innovation & Cost Savings: Beacon by LabCorp

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

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 on PRESS RELEASE: Compliance University Rollout

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 on Compliance Program Development Required by 2013