Zpic Audits Home Health

Inside The ZPICs How To Handle ZPICs - DecisionHealth
Sometimes the ZPIC conducts an unannounced site visit. The auditors take photos, copies of drivers’ licenses and records and turn the agency upside down. (See p. 31 for more about on-site inspections.) ZPICs more onerous than RACs While RACs have received more media attention, the PSCs/ZPICs are actually more worrisome for home health agencies. ... Access This Document

Surviving MAC, RAC And ZPIC Audits - Polaris Group
She has worked in the health care finance field at multiple corporate levels as well as own Long Term Care facility. She held the positions of Director of Operations, Regional Financial Consultant, Nursing Home Administrator, and Assisted Living Director. RAC and ZPIC Audits: Institute ... Access Doc

Beyond RACs: ZPICs, MICs, & MACs - Valuation
Beyond RACs: ZPICs, MICs, & MACs detecting, and deterring” Medicare fraud.3 ZPIC audits are based on a combination of claims data from various SNFs, Home Health Agencies, Physical Therapists & DME Suppliers”, Jackson Davis Healthcare, 2009, ... Access Full Source

Department Of Health And Human Services
Department of Health and Human Services OFFICE OF INSPECTOR GENERAL C MS AND CONTRACTOR O VERSIGHT OF (ZPIC) regarding activities to prevent improper payments on home health claims and to Home Health Prospective Payment System Rate Update for Calendar Year 2012 (76 Fed. ... Get Doc

Lisa Selman-Holman, JD, BSN, RN, COS-C, HCS-D, HCS-O
Home Health Insight—Consulting, Education and Products CoDR—Coding Done Right CodeProUniversity ZPIC 8 • Post Payment • Focus is potential for fraud • Billing trends Audits 14 Strategies ... Access Full Source

Five Mistakes To Avoid In ZPIC Audits - Federal-Lawyer.com
FIVE MISTAKES TO AVOID IN ZPIC AUDITS. DR. NICK OBERHEIDEN LYNETTE BYRD. 1-800-810-0259. Available on Weekends. INTRODUCTION. Oberheiden & McMurrey. advises clients from across the country with ZPIC audits, OESSA forms, and hospice and home health certifications. Our team of former federal ... Document Viewer

ZPIC AUDIT GUIDE - C.ymcdn.com
When a ZPIC audits a claim, they are auditing to make sure the requirements outlined in the LCDs and related Articles are met. Develop documentation checklists for your files to assure you always have all the necessary documentation. 3. Make sure your files are orderly and consistent. ... Access This Document

McBee Associates - YouTube
On this channel our consultants draw on their experience from the front lines of health care management, and share their insights Welcome to McBee Insights. ... View Video

Medicare, Medicaid Third Party - NAHC
Medicare, Medicaid & Third Party “The ZPIC has determined that it is likely you have been overpaid for the services provided from the end of the audit period through the current date based on FOCUS OF CURRENT RAC AUDITS Recent Home Health Risk Areas • “Homebound” requirement ... Fetch Here

The ABCs Of Medicare Audits And Appeals - C.ymcdn.com
•The Social Security Act provides that the Secretary of Health and Human Services (HHS) may perform any of his/her functions directly or by home health and hospice, Medi-Medi data matching. •Michigan ZPIC: Cahaba Safeguard Administrators ZPIC Audits •May use pre-payment or post ... Get Document

Zone Program Integrity Disclosures Contractor ZPIC Audits ...
Home Health, Hospice Dual Eligibility ZPICs do not review Medicare Parts C and D . 3/24/2014 4 ZPIC audits are based on data analysis of billing practices. ©2013 Health Integrity, LLC Zone Program Integrity Contractor (ZPIC) ... View Doc

New ZPIC Medicare Audits: Are You Ready?
New ZPIC Medicare Audits: Are You Ready? DME, Home Health and Hospice – Potentially will combine oversight of Medicare Parts C and D • PSC/ ZPIC will give you an opportunity to review and comment on report • Following receipt of comments, PSC/ ZPIC will go final on report ... Document Viewer

Medical Necessity - Defining And Documenting To Support ...
Medical Necessity - Defining and Documenting to Support Billing Presented By:Kim Garner-Huey, MJ, CPC, CCS-P, PCS, CPCO Know the Best Practices for Documentation of Medical Necessity, Critical ... View Video

FOTA - ZPIC Presentation.ppt
Supplier (DMEPOS), home health and hospice, and Medicaid services. RACs vs. CERTs vs. ZPICs • RACs → focus the majority of efforts toward adoption of CMS When a ZPIC audits a claim, they are auditing to make sure the requirements outlined in the LCDs ... Retrieve Doc

Medicare Audit And Appeals: Practical Advice On Preparing For ...
Medicare Audit and Appeals: Practical Advice on Preparing for and Responding to RAC, ZPIC, and MAC Audits Home Health, Hospice, Part B, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), Managed Care (Part ZPIC audits can involve a prepay or postpay review of ... Doc Retrieval

THE ULTIMATE GUIDE TO ZPIC AUDITS By Dr. Nick Oberheiden
THE ULTIMATE GUIDE TO ZPIC AUDITS. 888-452-2503. Available on Weekends. by Dr. Nick Oberheiden. areas of the health care industry include: Home Healthcare Services, Hospice Services, Durable Medical Equipment Suppliers, and Compounding Pharmacies. ZPIC investigators also utilize data ... Access Doc

OFFICE OF INSPECTOR GENERAL
The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, as amended, is to protect the integrity of the Department of Health and Human Services (HHS) programs, as well as the health and welfare of beneficiaries served by those programs. This statutory mission is carried out through a nationwide network of audits, ... Return Doc

CMS Manual System - Home - Centers For Medicare & Medicaid ...
Regional home health intermediary, carrier, and durable medical equipment regional carrier data) and other data to create a platform for conducting complex data analysis shall be documented in their Information Technology Systems Plan. By combining data from various sources, the PSC or the ZPIC will present an entire picture of a ... Access Doc

Home Health Audits: ADR/RA/ZPIC - Homecaremissouri.org
3/31/2015 2 Contract Issues with RAs January 14, 2015–Due to a post-award protest filed at the Government Accountability Office (GAO), CMS has delayed the commencement of work under the national DMEPOS/HH&H, Region 5, Recovery Audit contract. ... View Document

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers For Medicare ...
Submit claims to Medicare contractors (Fiscal Intermediaries (FIs), Regional Home Health Intermediaries (RHHIs), carriers, A/B Medicare Administrative Contractors (MACs), Durable Medical was made can request that the ZPIC for their zone investigate the case. The ZPIC will then work with ... Visit Document

MAC ZPIC UPIC MIC RACMAC, ZPIC, UPIC, MIC, RAC, CERT And ...
MAC ZPIC UPIC MIC RACMAC, ZPIC, UPIC, MIC, RAC, CERT and OtherAuditorsCERT and Other Auditors What Does it All Mean? Preseese ted bynted by: Howard Young, Esq. & • Describe the 3 most prevalent government health care program audits hospices are facing today. ... Access Full Source

Responding To Medicare Contractor Audits And Investigations
Responding to Medicare Contractor Audits and Investigations Kimberly Brandt country's home health and hospice providers RACs: Brief Overview. 3/16/2016 6 11 7 ZPIC zones ZPICs: Brief Overview. ... View This Document