Saturday, March 30, 2013

How Can I Learn How To Bill Medi-Cal Properly And Get My Billing Staff Trained?

For Medi-Cal providers, one of the most important things is for your biller, billing staff and office manager to understand the program, the rules and the upcoming changes. 

If you are a Medi-Cal provider, even one that only does occasional billing to the program, it is important to have your staff and biller as well. As a provider, you will be held responsible for what they do in billing.  So, what can you do that is cost effective?

First, even if your biller (third party or in-house) tells you what experts they are - remember that the rules and the way they apply them change constantly.  Anyone who says they know it all is to be regarded with caution. Change is the name of the game in healthcare billing.

Second, have your staff and even you sign up for the Medi-Cal Learning Portal. Anyone can sign up (even students or lawyers like me) and have access to recorded webinars, eLearning tutorials, quick links to provider manuals, information on upcoming seminars, contact information for regional representatives, and so on. You can even ask for a custom workshop through Medi-Cal. 

Third, have your billing staff attend Medi-Cal training seminars. For example, next month, on April 16 and 17, 2013, the Department of Health Care Services (DHCS) and Xerox State Healthcare, LLC [the DHCS fiscal intermediary] will conduct Medi-Cal training seminars.  This is also available for sign-up on the Medi-Cal Learning Portal linked above. On April 16, the training will for Allied Health, Long Term Care and CCS/GHPP providers only.  On April 17, the training will be for Medical, Inpatient/Outpatient, HAP, and  CCS/GHPP providers.

In order to be compliant and not have audits or accusations of fraudulent billing, keep records of the training and be vigilant about having your staff and outside billers staying on top of these issues. All too often, people are relying on old rules and the way things used to be and are not staying on top of or ahead of the issues.


  

Sunday, March 24, 2013

Jury Convicts Orange County Doctor Of Health Care Fraud In Federal Court


In the Central District of California, on March 6, 2013, a federal jury convicted an Orange County doctor Dr. Augustus Ohemeng, 62, of six counts health care fraud following a five-day trial. (CR No. 12-00415-CAS)

The conduct alleged to have taken place occurred from February 2005 to September 2009. The Indictment was not filed until May 2012. It has obviously taken years to get these cases charged and taken to trial. 

The codefendants in this case, which included another physician George Tarryk, all plead guilty. This case, like many others, involved marketers paying patients for visits and allegedly unnecessary wheelchairs and nutritional supplements being ordered for the patients. Judge Snyder allowed Dr. Ohemeng to remain on bond pending sentencing. 


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