PYA Senior Manager Valerie Rock authored an article, “New Payment Review Strategies: What to Do If You Receive an Outlier Coding Notice,” which was recently published in Medical Economics magazine. The article was written in reference to the relatively new practice of auditing individual providers with outlier service billing patterns as part of a new program, “Targeted Probe and Educate.” The program was implemented by the Centers for Medicare & Medicaid Services this August.
“Receiving a notice letter doesn’t necessarily mean that you are billing improperly. However, it is essential to evaluate your organization’s coding accuracy, as such notifications are likely a precursor to an audit. The following strategies can help you feel prepared and confident when, and if, this time comes.”
For additional guidance related to outlier coding notices, or to request a speaker on this topic for your organization or event, contact one of our PYA executives below at (800) 270-9629.