Millennium Healthcare Consulting, Inc

COMPLIANCE REVIEWS

Millennium Healthcare Consulting, Inc’s ®, certified coding and compliance consultants have extensive experience working with physicians, hospitals, healthcare executives, law firms and other healthcare professionals in identifying coding and compliance issues, and develop practical and effective compliance programs.

We work with your in-house legal counsel or we coordinate the process with one of your legal expert advisers. We conduct coding and compliance training, baseline periodic medical record audit reviews, and assist in refining work flow policies and procedures that have a direct impact on the revenue cycle.

Some of the areas of focus include, but are not limited to:

Coding Reviews and Monitoring

1. External Standard Audit: Part of the client’s ongoing compliance program initiatives-auditing, monitoring and educational component. These independent external audits should be conducted at least once a quarter as a apart of the ongoing compliance program initiative. MHC works with the designated individuals(s) at client’s sites to select a material sample of each provider’s high volume (dollar and/ or units) patient services.

2. External Targeted Audit: At times, the client may have specific areas of concern based on a general internal audit, denials received or updates from Medicare to other third party payors. These types of audits are best conducted under the auspices of external legal counsel.

3. E&M Coding Pattern Utilization Study: Snapshot of physician coding habits by respective specialty compared to industry norms. This profiling will assist practices/healthcare entities in identifying potential areas of compliance risks and/or reimbursement leaks.

Training and Education

MHC provides customized seminars for your staff and/ or physicians/advanced practitioners. The sessions can address any specific coding topics of interest to your healthcare organization/ Some topics may include:

Medical record documentation (evaluation and management, procedural or surgical services)
Explanation of current CPT/ICD-9 and Medicare changes.
Understanding claim denial reasons and overcoming medical necessity denials
Customize specialty specific topics

Administration-Clinical Compliance

Vulnerabilities/Risk Assessment Reviews.
Policy and Procedure Development.
Billing/Collection Procedures including Claims Denials/Appeals Process.
HIPPA Compliance.
Annual compliance training for all employees.