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Being Prepared For The ZPIC Audit Process Is Extremely Important

Ask healthcare providers about Zone Program Integrity Contractor (ZPIC) and they will tell you how difficult this audit can get for them. The auditors have the freedom to get any sort of data, details, and information from the healthcare providers if the healthcare facility is believed to be involved in some doubtful practices that goes against their code of conduct. If you’re an owner of a healthcare facility who is also facing a similar situation, then it is advised that you first find ZPIC healthcare audit counsel to be aware of your legal rights and comply with the request of auditors to provide all the relevant documents for inspection. Key things every healthcare facility should know about this audit: First thing you should know is that there are very few limitations on the ZPIC auditors. They are allowed to demand almost every kind of information by the provisions and you should comply with their requests. Be prepared for a prepayment review as well from the auditors. Do k
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Enhancing Coding By Using DRG Validation Services

DRG validation is a type of program which is used by many reputed healthcare organizations to bring down risk, defend claims and guarantee the accuracy of coded items. It also plays an important role in proper coding practices. The basic purpose of DRG validation is to assure that all patient information reported and coded by a hospital on its claim matches the information contained in the beneficiary’s medical record along with the physician’s records. That is why the best DRG healthcare companies can help coders realize the broad coding classification of services and conditions for convenient comparison when looking into the payment categories.        Listed below are facts about DRG validation systems as to how they can relate to coding — An organization must have options regarding the implementation of DRG validation, so that you can choose from either an internal coding staff or hire an outside vendor. Since DRG validation procedures and guidelines alw
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Importance Of Medical Post Payment Audit

It is necessary for all health insurance payer to regularly monitor their coding, billing, and documentation process done by the health care providers. This is necessary to make sure that there is no cases of fraud and abuse within the health care payment system. The insurer would request all the medical records from the provider in order to carry out the auditing process. After which all the documentation would be compared on the claim forms that were previously submitted and paid Under the best medical post-payment audit process, the department can only approve the medical documents that are less than $1,000 and without any requirement of prepayment auditing by the Payment Services. The documents approved by the department are then audited for compliance with payment rules on a post-payment basis — however, payments amounting to $1,000 or more are needed to be pre-audited. Some of the reasons why payment services need medical post-payment auditing are explained here. 1. To
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