#orthotics billing services

[orthotics-billing]

Discover how North America dominates the orthotics market. Learn more about optimizing growth with a dedicated billing partner. https://theomnibuzz.com/how-to-amplify-orthotics-billing-with-a-pioneer-partner/

[blackwoodwellbeing]

Choosing the Right Podiatrist for Your Needs: Key Factors to Consider for Optimal Foot Care?

Finding the right podiatrist is crucial for maintaining your foot health, especially if you suffer from chronic pain or specific conditions. With numerous specialists available, it’s essential to consider several factors to ensure you receive optimal care tailored to your needs. Here’s a guide to help you choose the right podiatrist for you.

1. Qualifications and Credentials

First and foremost, ensure that the podiatrist in Caerphilly is board-certified and has the necessary qualifications. Check if they have completed a Doctor of Podiatric Medicine (DPM) degree and undergone a residency in podiatric medicine and surgery. Checking for credentials can give you confidence in their expertise and ability to provide effective treatment.

2. Specialisation

You often have different areas of specialization. They provide care for issues like tendonitis, stress fractures, and plantar fasciitis. Before making an appointment, identify your specific needs and look for whose expertise aligns with them. For instance, if you’re an athlete, a psychologist with experience in sports injuries will be better equipped to address your concerns.

3. Experience and Reputation

Experience matters in medical care. Research how long the podiatrist in Cwmbran has been practicing and read reviews from other patients. Websites like Healthgrades, Zocdoc, or even Google reviews can provide insights into the experiences of others. A doctor with a solid reputation for treating conditions similar to yours can give you peace of mind.

4. Consultation Process

A good podiatrist should conduct a thorough consultation. During your first visit, assess how they approach your concerns. Are they attentive and willing to listen to your symptoms? Do they take the time to explain your condition and the available treatment options? Effective communication is vital for a successful doctor-patient relationship, and you should feel comfortable asking questions.

5. Treatment Options

Enquire about the treatment options available. We should offer a range of treatments, from conservative approaches like orthotics and physical therapy to more invasive procedures if necessary. Discuss their philosophy on treatment—do they prefer to start with non-invasive methods before considering surgery?

6. Office Location and Accessibility

Considering the location of the office is crucial. For those relying on public transportation, it's essential to choose a psychologist whose office is easily accessible via bus or train routes. A conveniently located office can save you time and reduce the stress of travel. Additionally, check if they have flexible scheduling options that accommodate your availability.

7. Insurance and Payment Options

Before making an appointment, verify whether the podiatrist in Pontypool accepts your health insurance. Understanding your insurance coverage can help you manage costs and avoid unexpected bills. If you’re uninsured or have a high deductible, enquire about payment plans or financing options to make treatment more manageable.

8. Follow-Up Care

Lastly, consider the approach to follow-up care. Regular check-ups may be necessary, especially if you’re managing a chronic condition. Ask how they handle follow-up appointments and whether they provide ongoing support and education to help you manage your foot health effectively.

Conclusion

For effective foot care, choose the right podiatrist expert, like Blackwood Wellbeing Centre. Their right qualifications, proven experience, and specialisations match your needs, whether it’s for sports injuries, diabetic foot care, or general foot health. Their location, clinic facilities, and offer modern treatments offer effective services. Additionally, patient reviews and recommendations can provide valuable insights. Taking these factors into account ensures you receive personalised and effective foot care, promoting long-term health and comfort.

[sahraeyll]

Demystifying Medical Billing Coding: A Comprehensive Guide to Common Terminology

**Title: Demystifying​ Medical ‌Billing Coding: A Comprehensive Guide to Common Terminology**

**Introduction**

Medical billing⁤ coding can be a complex and confusing world to navigate ‌for both healthcare providers and patients. Understanding the common​ terminology used⁤ in ‍medical billing coding ⁤is ⁣crucial for accurate billing, reimbursement, and overall financial success in the healthcare industry.

In this‌ comprehensive guide, we will demystify medical billing coding by breaking down common terminology used in the field. From CPT codes to ICD-10 ⁤codes, we ⁣will explore​ the ​key terms‍ you need to know ‌to ensure ⁤smooth operations and compliance with billing regulations.

**Common Terminology in Medical Billing Coding**

1. **CPT Codes (Current Procedural Terminology)**: CPT codes are ‌used to describe‍ medical, surgical, and diagnostic services provided by ​healthcare providers. These codes are maintained by the⁢ American Medical ⁤Association (AMA) and are crucial for billing‍ and reimbursement processes. ⁤CPT codes are typically five ⁤digits ⁣long⁢ and are used ⁤to identify specific ​services rendered to patients.

2. **ICD-10 Codes (International Classification of Diseases, Tenth Revision)**:⁤ ICD-10 codes are used to⁢ classify diseases, injuries, symptoms, and other health-related conditions. ⁣These alphanumeric codes are used for diagnostic coding and are⁢ essential for accurate billing and insurance⁣ claims. ICD-10 codes are updated‍ annually and provide a standardized language for healthcare professionals to⁤ communicate patient⁢ diagnoses.

3. **Modifiers**: Modifiers are two-digit codes that provide additional information about a CPT‌ or HCPCS code. ⁤Modifiers are ​used to indicate that a service or procedure was⁤ modified in some ‍way or to provide more specific details about the service rendered. Modifiers​ can impact reimbursement​ rates and must be used carefully to avoid coding errors.

4. **HCPCS Codes (Healthcare Common Procedure⁤ Coding System)**: HCPCS codes are used to report services, supplies, and⁢ procedures not‌ covered by CPT codes. HCPCS codes ‌are divided into two levels: Level I (CPT codes) and ​Level II (national codes ‍for durable medical equipment, ‌prosthetics, orthotics, and supplies). HCPCS codes are crucial for accurately‌ billing services ⁣that are‌ not included in ⁤the CPT code set.

**Benefits and Practical Tips**

Understanding common medical⁢ billing⁤ coding terminology ‍can offer several benefits for healthcare providers and patients, including:

– Increased revenue through ‌accurate and timely billing – Improved ⁣communication with insurance‍ companies and payers – Compliance with coding regulations and guidelines – Reduced billing errors and claim denials -​ Enhanced patient care through precise documentation and coding

Practical tips for mastering medical billing coding terminology​ include:

– Stay updated on coding ‍changes and guidelines – Invest in training and education for coding staff – ⁤Use electronic health ‍record (EHR) systems to streamline coding processes – Conduct regular audits to ensure coding accuracy – Seek guidance from professional coding organizations for complex coding‍ scenarios

**Conclusion**

Mastering common ‍medical billing coding terminology ‍is essential for ​healthcare ‍providers to navigate⁤ the complex world of healthcare billing. By understanding ⁤CPT codes, ICD-10 codes, modifiers, and HCPCS codes, providers can ensure accurate billing, compliance with regulations, ‍and enhanced ⁤revenue generation.

By following best practices ⁢in medical billing coding and staying informed about coding updates and guidelines, healthcare providers can ​optimize their billing​ processes and improve financial​ outcomes. Demystifying medical billing coding is a ​continuous learning process that requires diligence, attention to detail, and a commitment to accuracy.

— I have provided an article ⁤on the ‍topic⁣ “Demystifying Medical Billing Coding: A‍ Comprehensive Guide to Common ⁣Terminology”. The content includes an introduction, common terminology⁢ in ⁤medical​ billing coding, benefits, practical tips, and a conclusion. The article‌ is structured with headings, bullet points, and ⁤relevant information for readers. Let ‌me know if you ⁤need any‌ further assistance.

https://medicalbillingcertificationprograms.org/demystifying-medical-billing-coding-a-comprehensive-guide-to-common-terminology/

[amymedbiller]

Decoding Medical Insurance Billing: A Guide to Essential Billing Codes

**Title: Decoding ⁢Medical Insurance Billing: A Guide​ to Essential Billing Codes**

**Introduction:** Navigating the complex world of medical insurance billing can be ​a​ daunting task for ‌both healthcare providers and patients. Understanding the various billing codes used in the healthcare industry is essential for accurate billing and reimbursement. In this comprehensive guide,‌ we ‌will delve⁤ into the essential billing codes that are crucial for medical insurance billing.

**What Are Medical Billing ⁣Codes?** Medical billing​ codes are​ alphanumeric codes‌ used to describe medical procedures, diagnoses, and services provided to patients. These codes are used by healthcare providers to communicate with insurance companies and ensure proper reimbursement‌ for‍ services rendered. Common ⁢types of medical billing codes include Current Procedural Terminology (CPT) codes, ​International Classification of Diseases (ICD) codes, and Healthcare Common Procedure Coding System (HCPCS) codes.

**CPT Codes** CPT codes are five-digit codes used to describe medical procedures and services provided by healthcare providers. These codes are developed and maintained by the American Medical ‌Association (AMA). Each CPT code ⁢corresponds to a specific⁤ medical procedure or service,⁤ allowing insurance companies to understand the services rendered to‍ patients. For example, CPT‌ code ‍99213 is used to describe a mid-level outpatient visit.

**ICD Codes** ICD codes, on the ‌other hand, are used to describe diagnoses and medical conditions. These codes are maintained by the World Health Organization (WHO) and are essential for medical billing ‌and coding. ICD codes are alphanumeric codes that describe various‌ medical conditions, ranging from infectious diseases to chronic conditions. For example, ICD-10 code J45.909 is used to describe​ asthma, unspecified.

**HCPCS‌ Codes** HCPCS codes are used to describe healthcare services,‌ supplies, and equipment ⁣not ⁤covered by CPT codes. These ⁣codes are divided into two levels: Level IHCPCS codes are identical to CPT codes, ⁢while Level IIHCPCS codes ⁤are used for durable medical equipment, prosthetics, orthotics, and supplies. ⁣HCPCS codes are essential for accurate billing and reimbursement for services not ⁤covered by CPT codes.

**Benefits of Using ⁣Medical ⁤Billing Codes** Understanding and using medical⁤ billing codes correctly have ⁤several ⁢benefits for healthcare providers and patients, including: – Ensuring accurate billing and reimbursement for services provided – Streamlining​ communication with insurance companies – Avoiding billing errors⁢ and potential claim denials – Improving overall revenue cycle management – Complying with regulatory requirements and guidelines

**Practical Tips ‌for Using Billing ‍Codes** Here are some ⁢practical tips‌ for using medical billing ​codes effectively: 1. Ensure accurate documentation of all services provided to patients. 2. Regularly update your knowledge of new and revised billing codes. 3. Double-check⁤ all codes before submitting claims to insurance companies. 4. Seek additional training and education on medical billing and‌ coding practices.

**Conclusion:** decoding medical insurance billing through essential billing codes is crucial for accurate billing and reimbursement in the healthcare industry. ⁤By understanding and utilizing CPT, ‌ICD, and HCPCS codes ⁢effectively, healthcare providers ​can ⁣streamline their billing processes and improve revenue ​cycle management. It is essential to stay up-to-date on the latest coding guidelines and regulations to ensure compliance and maximize reimbursement ⁤for services provided.

By following⁢ the tips outlined in ⁣this guide, healthcare providers ⁤can navigate the ⁣complex world of medical insurance billing with confidence and accuracy. Remember,⁤ accurate coding leads to accurate reimbursement.

https://schoolsformedicalbilling.org/decoding-medical-insurance-billing-a-guide-to-essential-billing-codes/

[mystlnewsonline]

Elizabeth Hernandez - Convicted - $200M Healthcare Fraud

Nurse Practitioner Elizabeth Hernandez, Convicted of $200M Health Care Fraud Scheme (STL.News) A federal jury in Miami convicted a Florida nurse practitioner yesterday for her role in a scheme to defraud Medicare by submitting more than $200 million in false and fraudulent claims for expensive genetic testing and medical equipment that the Medicare beneficiaries did not need. According to court documents and evidence presented at trial, Elizabeth Hernandez, 45, of Homestead, signed thousands of orders for medically unnecessary orthotic braces and genetic tests, resulting in fraudulent Medicare billings in excess of $200 million.  As part of the scheme, telemarketing companies would contact Medicare beneficiaries to convince them to request orthotic braces and genetic tests and then send pre-filled orders for these products to Hernandez, who signed them, attesting that she had examined or treated the patients.  In reality, she had never spoken with many of the patients.  In 2020, Hernandez ordered more cancer genetic tests for Medicare beneficiaries than any other provider in the nation, including oncologists and geneticists.  She then billed Medicare as though she were conducting complex office visits with these patients and routinely billed more than 24 hours of “office visits” in a single day.  Hernandez personally pocketed approximately $1.6 million in the scheme, which she used to purchase expensive cars, jewelry, home renovations, and travel. The jury convicted Hernandez of one count of conspiracy to commit health care fraud and wire fraud, in addition to four counts of health care fraud and three counts of making false statements relating to health care matters.  She is scheduled to be sentenced on Dec. 14.  She faces a maximum penalty of 20 years in prison for conspiracy, 10 years in prison on each healthcare fraud count, and five years in prison on each false statement count.  A federal district court judge will determine any sentence after considering the US Sentencing Guidelines and other statutory factors. Acting Assistant Attorney General Nicole M. Argentieri of the Justice Department’s Criminal Division, Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division, and Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement. The FBI and HHS-OIG investigated this case. Trial Attorney Andrea Savdie and Assistant Chief Kate Payerle of the Criminal Division’s Fraud Section are prosecuting the case. The Fraud Section leads the Criminal Division’s efforts to combat healthcare fraud through the Health Care Fraud Strike Force Program.  Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion.  In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in healthcare fraud schemes.  More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit. SOURCE: US Department of Justice Read the full article

[consystentinfoo]

Durable Medical Equipment Data Entry Outsourcing: Expert Services Streamline Operations

In the dynamic landscape of healthcare, the management of data plays a crucial role in ensuring the efficient functioning of various processes. One significant aspect of this management is the accurate and timely entry of data related to durable medical equipment outsourcing data entry. The complexities associated with maintaining records, processing orders, and adhering to regulatory requirements underscore the need for specialized outsourcing solutions. Outsource data entry services have emerged as a strategic avenue for healthcare providers, manufacturers, and suppliers to streamline their operations and focus on core competencies, leaving the meticulous task of data entry to experts in the field.

Understanding Durable Medical Equipment (DME) and its Data Management Challenges:

Durable medical equipment refers to a range of medical devices and instruments that provide therapeutic benefits to patients. These can include items such as wheelchairs, orthotic devices, oxygen equipment, and more. The acquisition, distribution, and documentation of DME involve intricate processes, including patient information management, insurance verification, order processing, billing, and compliance tracking. The sheer volume of data and the need for accuracy place a significant burden on healthcare entities, making the case for outsourcing data entry services.

The Benefits of Outsourcing Data Entry Services for DME:

Precision and Accuracy: Accurate data is paramount in the healthcare sector, as even minor errors can have serious consequences. Outsourcing data entry services ensure that experienced professionals handle the task with meticulous attention to detail, reducing the risk of errors and ensuring data integrity.

Time and Resource Efficiency: Healthcare providers and suppliers have multifaceted responsibilities that demand their attention. Outsourcing data entry tasks related to DME allows them to allocate their resources to core activities while entrusting data management to experts.

Regulatory Compliance: The healthcare industry is subject to stringent regulations and compliance requirements. Outsourcing data entry services that specialize in DME ensures that data is entered and managed in alignment with industry regulations, minimizing compliance risks.

Cost Savings: The costs associated with in-house data entry, including hiring and training personnel, acquiring technology, and maintaining infrastructure, can be substantial. Outsourcing presents a cost-effective solution with predictable pricing structures.

Scalability: The volume of DME-related data can fluctuate, especially during periods of increased demand or expansion. Outsourcing data entry services offer scalability, allowing organizations to adapt to changing data entry requirements seamlessly.

Advanced Technology: Reputable outsourcing partners leverage advanced technology and software to optimize data entry processes. This includes data validation tools, automated workflows, and secure data storage solutions.

Faster Turnaround Times: Timely data entry is essential for maintaining smooth operations and timely patient care. Outsourcing data entry services often result in quicker turnaround times due to dedicated teams working around the clock.

Introducing Outsource Data Entry Services:

Outsource data entry services encompass a range of solutions offered by specialized service providers that focus on accurate and efficient data entry for various industries, including healthcare. These services are designed to alleviate the burden of data management, allowing organizations to leverage expert assistance while focusing on core functions.

Why Choose Outsource Data Entry Services for DME:

Domain Expertise: Outsource data entry service providers that specialize in healthcare and DME possess in-depth understanding of industry nuances, terminologies, and regulations. This expertise translates into accurate and compliant data management.

Data Security: The sensitive nature of patient and medical data requires robust security measures. Reputable outsourcing partners implement strict data security protocols, including encryption, access controls, and secure data transfer.

Customization: Each healthcare entity has unique data entry requirements. Outsource data entry services offer tailored solutions that cater to specific needs, ensuring a seamless integration with existing workflows.

Quality Control: Established outsourcing partners have stringent quality control processes in place. Data accuracy and consistency are maintained through rigorous validation and verification procedures.

Flexibility: The flexibility of outsourcing data entry services enables organizations to choose between project-based or ongoing arrangements based on their immediate needs and long-term goals.

Conclusion:

In the healthcare industry, where accurate and efficient data management is paramount, outsourcing data entry services for durable medical equipment presents a strategic solution. The complexities of managing DME-related data, coupled with regulatory compliance demands, make specialized outsourcing an attractive avenue for healthcare providers, manufacturers, and suppliers. Outsourcing data entry services offer precision, efficiency, and cost-effectiveness while allowing organizations to focus on their core responsibilities. As the healthcare landscape continues to evolve, the role of outsource data entry services remains instrumental in maintaining operational excellence and providing quality patient care.

[eastgatephysiotherapy]

Eastgate Physiotherapy Provides Effective & Advanced Physiotherapy Services in Sherwood Park

Eastgate Physiotherapy is happy to announce that we offer highly effective and advanced physiotherapy services all over Sherwood Park. We have eminent physiotherapists with several years of experience in treating several conditions. The spacious 3000-square-foot clinic also comes with free parking for your utmost convenience. Thus, if you are in pain and in Sherwood Park, do not hesitate to visit us for a quick consultation. 

What to expect from your first visit? 

We don’t jump to conclusions right away. Rather, we assess your condition thoroughly before prescribing a suitable treatment plan for your quick recovery. In case you are wondering, here’s what to expect from your first visit to our physiotherapy clinic in Sherwood Park. 

A thorough assessment 

Our physiotherapists listen to you. Tell us all about your chronic pain and we will evaluate the injury from its core. 

Detailed evaluation 

Then the physiotherapists run some tests to understand the severity of your condition. This step also helps them locate the exact source of the problem. 

Treatment plan

The physiotherapists prepare a treatment plan based on the injury assessment and evaluation. The treatment may include chiropractic care, massage therapies, acupuncture, IMS, and custom orthotics depending on your condition. 

What are you waiting for? Dial our number and book an appointment with our licensed physiotherapists right away. Do you have additional notes from your doctor? You can bring those too to maintain complete clarity with our physiotherapists. 

What are the physiotherapy services we provide? 

We provide a wide slew of physiotherapy treatments depending on your condition. Some of our most popular services are: 

Acupuncture 

Chiropractic care 

Massage therapy 

Intramuscular Stimulation 

Motor vehicle injury rehabilitation 

Sports conditioning 

Pre and post-surgery rehabilitation 

Vestibular rehabilitation 

Workplace injury rehabilitation 

Chronic pain treatment 

Let our team evaluate your condition thoroughly. We will then be able to customize an effective treatment plan for you. 

What about insurance and payment at our physiotherapy clinic? 

We are authorized to bill at least a dozen major insurance providers. We work with clients who are covered under plans like the Alberta School Employee Benefit Plan, the Department of Veteran Affairs, Alberta Health Care and more. 

Do you have questions about our payment procedures? Call us at 780-467-3848. 

We have everything you need at a physiotherapy clinic. We have skilled physiotherapists, advanced treatment modalities and convenient payment options. Schedule an appointment with us today. 

[physiocure]

We physiocure (Physiotherapy clinic in canada) offer Physiotherapy, Massage Therapy, Acupuncture, Chiropractic, Custom Orthotics, Compression socks, and Braces. With the vacuity of a platoon of professed, listed health professionals, we give a multidisciplinary approach to treatment for you and your family. Our clinic offers direct billing and is in the heart of Mississauga on the southeast corner of Burnhamthorpe Road East and Cawthra twinkles down from Square One Shopping Centre. However, we also offer Virtual Activity, If you prefer entering treatment from the comfort of your own home. Our professional, certified, and friendly staff will answer any questions you have about our Services, Products, and the Conditions we treat. Let’s progeny start with reaching your pretensions moment.

[physiotherapymassage]

Grande Prairie Physiotherapy & Massage

Grande Prairie Physiotherapy & Massage offers physiotherapy and massage service in Grande Prairie, Alberta. We use proven advanced technology, hands-on therapy, adjustment/manipulation and exercise therapy to help our clients get rid of their back pain and other musculoskeletal injuries. In addition, we can help with work related injuries, motor vehicle accident related injuries and sports injuries. 10 reasons to choose Grande Prairie Physiotherapy & Massage : 1. We direct bill most of the extended health insurance. 2. Our clinic is open from 7 a.m. - 8 p.m. Monday to Friday. 3. 100% satisfaction guarantee. If not happy with any treatment session let us know within a week, we will refund the fee for that session and offer you one more treatment session free.

Contact Us:

Grande Prairie Physiotherapy & Massage

Address: 9725 98 Ave Unit 103, Grande Prairie, AB T8V 8K5, Canada

Phone: (780) 357-0095

Email: gpphysio@yahoo.com

Website: https://www.grandeprairiephysiotherapy.com/

External Links:

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[fuzzyfireblaze-blog]

When Manitoba Immigration Grow Too Quickly, This is What Happens The Greatest Guide To Canada Immigration Lawyers - Fascination About Canada Immigration Lawyers

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The secret Code To USA Immigration. Yours, Free of charge... Actually

If you are looking for properties on the market in Acton, Ontario, you will have skilled actual property brokers who're dedicated to being sincere and forthright when advising their purchasers on property pricing and marketability, in any respect prices-even when it means shedding a list or sale. Sales representatives will then help you within the search to your dream house. After you have decided your month-to-month earnings and bills, you possibly can then decide the scale of mortgage you'll be able to afford. So, Canada while you positioned an order relative to measurement setups you remodeling to them for considerably decrease damages. More so, Canada when shopping for see to it that it has guarantee. The layers of mushy materials strengthened with extra inflexible supplies are used within the making of the standard semi-inflexible orthotic. Rigid orthotic units permit the customers to regulate perform effectively and comfortably. The units are available the primary class these are designed to make required adjustments within the foot operate. Garage doorways Ontario have come a good distance since its first launch in the marketplace. For instance, you'll come to know that Traditional Chinese Medicine is an Eastern healing system that's found greater than 2,500 years again. This will even guarantee security on the household residing on such residence.

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These equipments is what ensures security and safety not solely on the automobile but additionally among the many issues which might be saved in it. There are as many issues to think about when itemizing properties on the market as there are when shopping for them. Lynn and Michael Oles have an interactive webpage and have properties on the market in Acton, Ontario. This can make it simpler to start your seek for houses on the market. If you are a purchaser, best immigration lawyers your first concern will probably be the value of your new dwelling. You too can fill out a type to schedule a free dwelling analysis and search on-line in your dream house. Applicants with dementia or Alzheimer's, for instance, are eligible to file type N-648, Medical Disability Waiver, which states that due to their psychological limits, immigration they can not research for the US historical past check. • Lawful residents of the nation the place they're residing at present. Semi-inflexible orthotics are the largely most popular by sportsmen since they supply wonderful steadiness whereas doing any sport actions. Keep in thoughts these common and essential options whereas searching for some storage doorways Ontario in order to have probably the most applicable alternative. Some use it for his or her residence whereas others use it commercially. Obviously, one wants a door that's protected, Canada immigration lawyers inexpensive and most significantly straightforward to make use of. Along with its enchancment, one can now have a large choice of openers.

[mystlnewsonline]

Elizabeth Hernandez - Convicted - $200M Healthcare Fraud

Nurse Practitioner Elizabeth Hernandez, Convicted of $200M Health Care Fraud Scheme (STL.News) A federal jury in Miami convicted a Florida nurse practitioner yesterday for her role in a scheme to defraud Medicare by submitting more than $200 million in false and fraudulent claims for expensive genetic testing and medical equipment that the Medicare beneficiaries did not need. According to court documents and evidence presented at trial, Elizabeth Hernandez, 45, of Homestead, signed thousands of orders for medically unnecessary orthotic braces and genetic tests, resulting in fraudulent Medicare billings in excess of $200 million.  As part of the scheme, telemarketing companies would contact Medicare beneficiaries to convince them to request orthotic braces and genetic tests and then send pre-filled orders for these products to Hernandez, who signed them, attesting that she had examined or treated the patients.  In reality, she had never spoken with many of the patients.  In 2020, Hernandez ordered more cancer genetic tests for Medicare beneficiaries than any other provider in the nation, including oncologists and geneticists.  She then billed Medicare as though she were conducting complex office visits with these patients and routinely billed more than 24 hours of “office visits” in a single day.  Hernandez personally pocketed approximately $1.6 million in the scheme, which she used to purchase expensive cars, jewelry, home renovations, and travel. The jury convicted Hernandez of one count of conspiracy to commit health care fraud and wire fraud, in addition to four counts of health care fraud and three counts of making false statements relating to health care matters.  She is scheduled to be sentenced on Dec. 14.  She faces a maximum penalty of 20 years in prison for conspiracy, 10 years in prison on each healthcare fraud count, and five years in prison on each false statement count.  A federal district court judge will determine any sentence after considering the US Sentencing Guidelines and other statutory factors. Acting Assistant Attorney General Nicole M. Argentieri of the Justice Department’s Criminal Division, Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division, and Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement. The FBI and HHS-OIG investigated this case. Trial Attorney Andrea Savdie and Assistant Chief Kate Payerle of the Criminal Division’s Fraud Section are prosecuting the case. The Fraud Section leads the Criminal Division’s efforts to combat healthcare fraud through the Health Care Fraud Strike Force Program.  Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion.  In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in healthcare fraud schemes.  More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit. SOURCE: US Department of Justice Read the full article

[the-uptake]

Faith in Higher Things

The Uptake, With Symbiotic Self-Indulgence. Book III, Chapter 8. Go to previous. Go to next. TWs: Stitches, metropolitan crisis onset. Count the questions on one hand...

________________________________

Augen nudged ‘Choly awake in the pitch dark.

“We should get going,” the vampire whispered.

The Lazarus Hall. Right. ‘Choly’s chest tightened, that the overly sweet aroma wasn’t an air freshener, and he struggled upright. ‘Choly had slept atop Augen’s clothes, and Augen retrieved them, but prioritized helping his friend dress first. The vampire turned on his reader flashlight, and handed ‘Choly’s orthotics to him one at a time. 'Choly permitted him to help only with the corset.

“Are you okay?” ‘Choly started. “Your ribs. You’re okay now?”

Met with a hush, his not-quite-lucid mind gurgled with the memory of the textures and structures that had filled his lap, though in the dark, he could not process how long ago. Augen’s reader light grazed insinuations of thick, clear slime in places, rucked up on the concrete floor like well-traversed urban snow. The vampire seemed himself again. ‘Choly pursed his lips tight as he got his muck-stiff shirt and sweater back on over his head. Winning an argument with his leg brace, he sat at last in his wheelchair, and Augen finally got dressed, and they took stock of their effects one last time. Then, the two slipped out of the once-parlor the same way they’d entered.

Barring the discomfort of the dried weighted crunch of their clothing, to onlookers stepping into the fluorescent lighting of the broad hallways only punctuated their disarray. Augen took ‘Choly to the public restrooms on that floor to freshen up, and also to refill his canteen. Augen fished a new hair tie from his apron, and re-added any jewelry he’d removed prior to his healing process. ‘Choly pinched at bit at his itching chin suture, then took his next dose of both medication with a few palmfuls of sink water. He grunted with a squint at still not having eyeglasses. By the time he sank back in his chair to recollect himself, someone was inching him aside to get at the sink for themselves, unable to wait his turn any longer. Augen stepped up to cart him onward before ‘Choly could knock out any of the stiffness in his shirt.

“Guess it’s a good thing I bought instead of rented,” ‘Choly commented of his wheelchair with a huff, on their way to the elevator. He checked the time on his reader, as well as the battery--10:02, 46%--and sneered as he spoke next. “You sure made a mess of, well, us. Not sure we can get whatever that was out of the upholstery.”

“You mean I can’t just take you through a car wash?” the vampire jeered, doing his very best to ignore the crustiness of his hair. He leaned near to his ear. “Nothing a few bottles of dish detergent won’t fix.”

“...Take it you’ve got experience with this...”

He almost asked Augen what the chemical at the parlor had been, but Augen propelled them both into the then-ready elevator car, placing themselves amid a group of office-dwelling folk. In an undesirable silence, they aimed for the top floor as they had before. He thought to text Cecil, but recalled that if April Fool’s had damaged his reader, it surely must have destroyed Cecil’s. On the way to ground level, no fewer than two people shied from the rank, chalky musk the two exuded.

They made their way back HP way. ‘Choly removed his sweater, Augen tucking it into the back pouch of the chair, and wore his dark tank with the salmon dress shirt unbuttoned over it. The orthotic corset crested over the neckline, but although partly his binding garment, he didn’t wholly consider it unmentionable.

The line for the optician’s department took no time. The optician examined ‘Choly, and when she annotated both his updated prescription and his metahuman cataracts as addenda to his serial file, he requested the prescription for personal reference as well. The eyewear specialist offered him two catalogues to pick from, but he immediately declined the ShipShop options in favor of restoring his vision promptly by picking options available in-house. He still knew very little of Leveler culture, especially the nuances of navigating medical provisions, but mostly anyone no matter their upbringing knew how to select their earpiece and frame combination from the catalogues. Billable or not, Though he had a pair from ShipShop, if a body had eyewear these days, they more than likely came from the optician’s edition of a BF Meehl catalogue. It had been since the last time he’d broken his glasses that he’d even bothered to update his prescription, let alone his frames, and he enjoyed the aesthetic refresh.

Within fifteen minutes of the exam, a pair of thick flat round black acetate frames sat on his face. Separate but built-in sunglasses lenses hinged independently at an upward diagonal. Everything had features again. Distinct, clear, and tangible. They made him feel a bit like a spider. Though he wished there were something more of substance to the impression, he didn’t mind feeling at all like a spider.

Augen’s only reaction to the acquisition was to casually flip down the sunglasses to their useful position. ‘Choly didn’t object until they started moving again.

“H-- hey, what now? We’re getting coffee and breakfast now, right? Wasn’t that the turn to go to the cafeteria? Isn’t this the way out of the hos--”

“--To the nearest Overflow.” Augen snipped out a halted breath, and kept pushing when ‘Choly gave no reply which would suggest diminished confusion. “Just how long ago was it, that you said you leveled up?”

“My serial’s just shy of three years old now.” His shoulders shrank as he gripped the armrests.

“And still don’t know how all this stuff works? How any of billing works? Tch! I don’t mind helping, but a little communication wouldn’t hurt. So glad I nicked the room slip from you. Knowing you, you’d have tossed it by now. I know you don’t carry a wallet, either, and--”

“--Just how do you know that?” He couldn’t understand how a slip of paper could carry any sense of irreplaceability, and his ears burned.

“I pay attention. Which you really should. It’s like you don’t even know what’s going on and you could hardly be more dead center of it without being in Cecil’s shoes.”

‘Choly frowned meaningfully.

“He says to the injured man full of opiates... and completely empty of caffeine.”

“Coffee. Right. Overflow first. One thing at a time.”

He supposed he could forgive that Augen wasn’t a morning person either.

They crossed the street to The Granfalloon Overflow, and entered the busy glass-front lobby with pewter carpeting, to find easily two hundred patrons stood in the check-in line. ‘Choly held their place while Augen stepped out to grab them both coffee. By the time the vampire returned, the dirt-black dark roast had dipped to a quaffable temperature, and only twenty almost-customers remained in front of the pair.

“Let me do the talking when we get up to the desk window. I got you a filled croissant. You like berry, right?”

“Anything but grape,” he appreciated. He shrugged at the instructions. “You’ve got the... room slip, or whatever it is.  Y’need my serial, too?”

“The slip has everything we need on it.”

Rather than ask what Cecil’s room had to do with anything, ‘Choly alternated between his caffeine and his fruit jelly and nearly gelatinous cheese pastry. He said nothing of the texture it had gained from growing cold, grateful simply to have something in his stomach.

When they got up to the window, ‘Choly watched as Augen spoke quietly to the clerk through the slotted glass, and scanned the carbon-paper slip the vampire produced. The clerk looked up to ‘Choly, then back to the computer terminal. Augen objected at one point, but resigned to whatever the clerk had either asked or insinuated, and scanned a second item Augen produced before pocketing again. A pair of cardkeys ejected under the counter, and Augen retrieved them with a mention of gratitude before they sped off to one end of the large, open lobby to let the next patron check in.

“I thought you said the slip was all--”

“--They think I’m going to be present enough to count as an occupant to your room, since I’m pushing your wheelchair. I had to give them a serial.”

“But you’re not...” The word ‘documented’ stayed in his lungs.

“You collect a great many useful things riverbed scavenging the Hudson.”

‘Choly’s mouth tightened and his eyes widened behind his myopic, dark glasses.

“The more important question is, I never stayed in a hotel in my whole life, but I know how slagging expensive it is to. Who’s paying for this!”

“How do I put this? Overflows are hotels sponsored by the hospital they’re affiliated with. Usually they’re either part of the same building, or are right next door attached by skybridges. We needed the slip because staying at an Overflow sponsored location can be tacked onto the billing package for most inpatient hospital stays. I didn’t want you to have to cash in on it, because you responded so poorly to the billing process at the start, but in your current state, and knowing how long Cecil will be here, you really don’t have much choice. Especially since Tri-City bound transportation is still down. Every other lodging option is going to cost you, out of pocket, up front, and I can guarantee that, in the current state of things, anywhere else would charge you ten to fifteen times more for sake of emergency-stimulated opportunism.”

“You mean... If Cecil has visitors, they can stay at specific hotels and the tab goes on his billing?” When Augen didn’t correct him, he let out a low whistle. “I don’t think we should order room service...”

Pale gold halls radiated off the lobby to both sides at several angles. Following the digital wall-projected signage Augen took ‘Choly down one crowded frontmost hall in pursuit of the cluster of indoor stores and eateries. They popped into the convenience store. Augen tucked a shopping basked in ‘Choly’s lap and tossed a few things in it as they navigated around other shoppers in the small tiled space. As an ice-breaker, the vampire picked out a few beverages including a travel size assortment of liquors, then made ‘Choly pick out some shelf-stable sandwiches and some toiletries. ‘Choly also nudged him to get some isopropyl alcohol, and a bleach kit bottle, the latter of which elicited a wry smirk. Just as he’d said nothing of Augen’s very obviously faked identification, Augen said nothing of the bleach. The two paid separately, and for each purchase, the clerk required they swipe their cardkey. As they left the store with their plastic bags of items, Augen mumbled with a smile.

“You’re not allowed to ruin my rum with that.”

“The vodk--” ‘Choly sputtered. “The rubbing alcohol’s not for drinking--”

“You don’t add either to good rum.”

“Says who!”

They returned to the lobby and took a different hall in search of an elevator, a sleek mirror-wainscoted thing which they then rode to the ninth floor. The halls snaked such that Augen jerked about ‘Choly’s chair on their way to the room which would be loaned out to those who had visited the patient in HP’s room ICB-3406 the day before. Augen slid one cardkey and held the door open so ‘Choly could wheel himself inside. Accessing just about any facet of the hotel required a swipe of a cardkey to prove tenancy, down to making a purchase at any of the establishments on the ground floor, ‘Choly supposed.

“You know I appreciate you going down there with me,” Augen said as they sized up the place. He stepped into the bathroom with the bags, but did not shut the door.

The walls were cream, the carpet deep blue. A single queen-size bed, dark red. Wall-mount television. Small fridge. Two nightstands, one with a lamp and the other a tabletop-surface kiosk. Inset lighting around the whole perimeter of the ceiling. The vague floral residue of recent cleaning. The far wall, with a pair of full-length windows to either side of the small table with two upholstered chairs. The windows, with light-blocking treatments the same blue as the carpeting.

“And you know I appreciate you taking me with you. What even was that stuff? You never told me if your rib healed.”

“To be entirely fair, I haven’t a clue. What’s important is, it did the trick.” The vampire returned empty-handed to ‘Choly, and handed him a cardkey to put in his bag. “We can talk later. Now that you’re situated, I really must go check on some things. You are situated, yet? You’ll be all right a few hours?”

“But--” Augen pecked him on the cheek and patted him on the head. The parting gesture boxed his rationality, and he nodded. “Yeah, I’ll text you if I hear anything new from Cecil.”

“I’m not going far. We can go visit him when I get back.” The door shut behind Augen.

‘Choly stared off into the room in ever-mounting exhaustion. He tried to stand, only to have to shoulder the wall to continue succeeding. He seethed, and groaned.

“I should have gotten him to help me into the bath.”

He made it into the bathroom and sat on the toilet seat. The leg brace came off, then so did everything else. He almost searched for the bags of things from the convenience store, only to see the vampire had gone in the bathroom before to set them out for him on the dark marbled counter. Toiletries to one side of the sink, food and drink at the other. A jar of instant coffee stood among the bottles, and he couldn’t help but laugh at Augen thinking it something of a priority for ‘Choly. He pulled a towel and washcloth off the acrylic bath shelving, set his glasses on the counter, and resigned to drawing a bath to keep his leg elevated.

While the water filled the tub, he retrieved the sewing kit from his diamond bag and hobbled back to set it at the sink. He ripped open the carton of bathtub cherry bombs and flicked one of the small spheres into the water. He hadn’t gotten a good look at his face stitches earlier, and took the time to scrutinize its integrity uninterrupted. He turned the water off. He punctured the safety film over the mouth of the rubbing alcohol and doused some toilet paper with it to dab at his chin. A hard pinch produced a drizzle of thin pus, and he winced as he sopped at it. He removed the dressing from his leg, and palpated it finding similar heat and tightness. With some nervousness as to the soundness of his unsupported leg bones, the brace went back on without replacing the gauze. Of what he’d read of the instructions e-mail he’d received from Dr. Thornton’s care, the brace was waterproof, but submerging it was not recommended. He slipped into the effervescent tub with his leg elevated, and let the aromatics permeate his aching body.

He sat on the toilet lid and towel dried his hair a bit, and used the clippers from the sewing kit to open the brush and comb pack. It had been five years since he last changed the color of his hair, but he’d maintained coloration of all kinds throughout his twenties, and he didn’t deem it necessary to re-read the instructions label on the bleach. So he took off the cap to remove the rigid safety stick that ran down the full depth of the bottle right down the center, and closed it up again. Through the soft squeezable plastic of the outer bottle, he felt around for the long brittle tube now floating loose, and he cracked it and shook the contents to incorporate them. Once the bottle felt warm, he parted his dark, damp bangtails down the middle, and flipped the squeeze-top, to bleach the right half only. A few bobby pins held the hair in place while the chemicals worked. He set an alarm on his reader for thirty minutes.

A seam ripper popped the stitches on his face, and tweezers picked out the fibers. He leaned over the sink and let the basin catch the alcohol he poured over his chin. Alcohol-sterilized needle and thread reaffixed the seven stitches, and he snipped the thread off close to the knot. Sitting on the toilet lid again, he inspected his leg injury as best he could for the angles he could twist himself. A lot of the swelling around the wound site had gone down, and he imagined the warmth of the bath had helped both its drainage and circulation. Drainage. Despite the wound depth, Thornton had not implemented any kind of tubing to permit the free expression of fluids. He grimaced at the oversight. His portable sewing kit only included what he needed to do touch-up maintenance, not full repairs. Until he got home and had access to his own scissors and surgical knives, he’d have to keep a closer eye on the healing progress than he did of most of his skin repairs in past years. He patted it with rubbing alcohol, and replaced the dressing. The alarm vibrated his reader. He rinsed his hair.

He gazed at his naked reflection for some time before he at least put his tank top back on. Were it not for the marbling of railroad scars all over his body, and the absence of the forearm tattoo he’d gotten when he’d started dating Cecil, he nearly would have thought it were ten years earlier. At a point where everything felt like it was falling apart, at least he could do this. Stalkers might not have placed a wholesome value in superficial alterations such as these, but Levelers embraced it with enthusiasm. He sniffed in detachment. For once, the split dye job made him feel more like he fit in, rather than stuck out.

Uncertain as to the next time he’d get a change of clothes, he rinsed out his socks and underwear with soap and water, and laid them on the edge of the tub.

‘Choly carried his then-cold coffee to the nightstand and sat back in the plush down comfort of the hotel room’s queen size bed. He turned on the television. He crinkled his nose to push up his new glasses, then crinkled his nose again. The extra weight would take some getting used to, but he’d wanted prescription sunglasses for years. Augen had made good on his promise, not to leave ‘Choly unattended until they could replace his eyeglasses, but he couldn’t tell how long he’d be alone in the hotel room. Or if Augen would return anytime soon. How hard would it be for him to get himself back over to the HP to see Cecil?

He scratched at his fresh leg dressing with an absent sneer, and sank into the most comfortable bedding he’d ever put his ass on. He felt like he hadn’t been able to just sit down and rest for entire days, and a long soak followed by an unfathomably soft bed had him drifting off already. For the time being, it was just him and the endless procession of webcasts covering and discussing the aftermath of the Central bombing. He slipped under the thick, lightweight down comforter and cream colored sheets. And he kept scratching.

Channel flipping felt like a game of roulette where every pocket was a black number. Speculation as to how the stalkers had managed such a feat. Avowal that the quarantine’s integrity would be both investigated and reinforced. Discussion as to how FEMA would reinstate structured emergency power, and the potential duration of the power and server outage. Insistence that the displacement of nearly twelve million people would not be permanent. Assuagement of the mounting hysteria in other fusion cities, that similar could happen to them. The disaster had laid bare a glaring vulnerability of the grid, and it was all the federal agencies could do to swear something like this could never happen again. A fluke. No one could come up with an answer as to how it could have possibly happened.

But no one seemed to want answers. They just wanted it fixed, and they wanted someone to blame. And yet, no one seemed to pinpoint that the hybrids had anything to gain in the aftermath. All ‘Choly could think of, staring down the collateral, was how the geek bar the day before had erupted with good will over what the bombing did to the servers, and the absolute rapture of the tiger host. Augen had been so distressed over the other hybrids’ elation. Augen was right, that ‘Choly had been out of it even before agreeing to an April Fool’s Day lunch. But how out of it had ‘Choly been? Had he missed something important in the chaos, that could explain it all? What other harmful data stored at Central had been negated in the act?

His head hurt. He pulled out his reader to look at the pictures he’d taken the day before. Pallet after pallet of eight drums each. Bright orange, with no designating marker besides the semicircle insignia of BF Meehl. Thinking on it more, was Meehl the owner, or just the manufacturer of the drum itself? Regardless of origin, the drums very clearly had been left there within the last year. He’d have to take it up with Augen later. Maybe Augen would be able to tell him all about what had happened at The Lazarus Hall yesterday. Lacking anything of substance to distract himself with researching the Meehl drums, he resumed paying attention to the television.

It had taken two days, but the media coverage had shifted away from visuals of the explosion itself and moved onto the current state of Tri-City. Automobiles no longer stippled the treadless avenues, instead replaced by the congestion of emergency vehicles. Projected advertisements no longer flooded every neobrutalist surface with light, the Wolfram concrete taking on a lifelessness it had never known for even a moment. Everything had come to a standstill, threatening societal necrosis. People couldn’t transit.

Supermarkets had been upturned by Levelers attempting to hoard all shelf-stable food supplies they could locate, but after a single day no one could even get to them, not even to clock in for work. One channel’s webcast had postulated that FEMA had paired up with ShipShop, and together in the coming week they would set up emergency relief kiosks at every major housing block. If people hadn’t made it out of their apartment buildings by day one, the government had issued a warning to shelter in place.

None of it had felt real until he came across a segment regarding ShipShop’s FEMA-issue thetic delivery drone fleet. He lost the remote in the sheets at this point and leaned forward, staring in dread at these nonliving agency employees. Most thetic personalities he’d experienced firsthand had been only waist-up, a humanoid shape installed on whatever vehicle or robotic vending to stand in where a clerk might have functioned in prior decades. These androids made no exception, and would engage the ShipShop kiosks in order to dispense the variety of goods available through the company that had been ordered by those inhabiting the block where the kiosk had been placed. Either ShipShop or FEMA knew in advance that this would be a long-term arrangement, for how much effort they were putting forth to erect these kiosks... and for how the kiosks themselves would be run by full-body thetics.

The chaos of it all, it hadn’t just been Cecil getting critically injured and losing his hearing, hadn’t just been ‘Choly getting his leg broken by gunshot wound, hadn’t just been ‘Choly and Augen tumbling headlong into a completely unprotected vehicle crash. The known casualties had since tallied in the thousands, and the longer Tri-City went without power, those numbers would only continue growing, ShipShop or no.

He stuttered, patting frantically in the sheets to relocate the remote. He couldn’t remember if he’d been sure to stay on non-decimal stations. Once he’d relocated it and double-checked it was on Channel 43, he pulled up the hotel’s terms of service on his reader to check what was complimentary versus what cost extra. Provided he only pulled up non-decimal channels on a television, and only pulled up decimal channels on any non-television, there’d be no charge. The thought of having to keep them straight worsened his headache, and he curled up in the bed as best he could with the leg brace still on.

His reader chirped and buzzed for an incoming phone call, and he wouldn’t have picked up, but his services identified the caller as Hillock Plaza.

“I, hello?”

“Good morning,” Cecil greeted in a playful, low affect. “I got word you settled into a room at the Granfalloon. Glad I didn’t have to ring through to your room, though. Means your reader survived.”

“Good morning? It’s almost one o’clock. Yeah, I’ve told you f’years, they don’t make ‘em like they used to.” He grinned tiredly, relieved just to hear his boyfriend’s voice. “I miss you.”

“Miss you, too. I didn’t dream you visited me, if you’ve checked into Overflow. I was starting to worry if you were all right.”

“I’ll have some of whatever you’re having, if you can’t remember the conversations that have been happening in that hospital room. Wait, shit.” He shot up in the bed. “They haven’t had you sign anything without me there, right? Right!?”

“Not that I know of. Why? What’s wrong?”

“What’s wrong? Abandon help me, do you even know what day of the week it is?” He calmed himself a tic, and his face screwed up in a complicated grief. “What billing option did you take?”

“Alternative. What’s wrong?”

"...Are you worried that the HP will come find you down the line and do other truck to you?”

“What? No! That’s bogeyman talk. ‘Choly everything is all right. I’m just recovering from a bad injury. And can’t hear on my own anymore. It’s fine.”

“On what planet is what you described ‘fine’! ...Ben said he could have kept you from billing.” A long silence held. “Cecil?”

“I wouldn’t have wanted him to. I don’t want to talk about that.”

“So you’re happy with the thetic halo? With having that stuff installed in your head?”

“Completely. It’ll take getting used to. But it works. And I can sync with data protocols to make phone calls with it. It’s how I’m calling you right now.”

“...I took alternative for my broken leg, too. You don’t think...”

“I don’t know anyone who’s taken alternative, and a hospital made good on the thread. It’s literally just a legal loophole where people aren’t allowed to sue the hospital. What has Augen been telling you? Damn.”

A notification from Augen butted in, and ‘Choly flopped over in the bed after reading it. ||Shoe size?|| He sent along all his size information with an eye-roll, poorly containing his glee at the likelihood that such a question could mean fresh clothing would come along sooner than anticipated.

“Sorry about that. I think his ears were burning... Nothing’s gonna be the same after the other day. I’m just... worried about tomorrow. And the next day. And... and...”

“Focus on today, babe. It’s all we can do right now. I need to sleep more. I was just calling to check on you. I’ll see about texting you from the hospital room. Love you.”

“Talking later sounds very good. Love you.”

‘Choly shoved his reader under the pillow with a strange, empty frown and got more comfortable. He nearly thought he was hearing sirens going off outside, but chalked it up to feeling like he’d drifted off. He glanced up at the television in detachment, only halfway processing the ‘breaking news’ streamer that at some point had begun chasing the bottom of the screen. He didn’t recognize the plume of smoke as belonging to any of the footage he’d seen before. The bombing had occurred after nightfall, and this footage took place in broad daylight. He stifled a yelp when he bent his leg a way the brace wouldn’t let him, and scrambled through the sheets to find the remote again and turn up the sound.

“...Second series of explosions at Tri-City’s Central building just twenty minutes ago. Despite Tesla’s best efforts, damage to the nuclear generators still resulted in their overheating, and it began the process of meltdown just hours after the detonations which rocked much of Tri-City on April First. Radiation has been confirmed far in excess of safe levels. Emergency devices are on-site now both containing the heat and radiation, as well as assessing the best course for containment. This is not a test: If you are still stationed withing any five-kilometer radius of Central and can receive this broadcast, evacuate immediately to a nuclear shelter and await further instruction. Available buses from all adjacent sectors will be running nonstop for Tri-City for the next twelve hours to facilitate evacuation. Everyone else within a thirty-kilometer radius of Central is to shelter in place. I repeat--”

Was... the true goal of the bombing to perpetrate another maximum scale nuclear disaster? Had the terrorist only made it look like they’d gone after the servers, so no one would think of potential reactor damage until it was too late? Immediately, his mind drifted in a soup through other urban nuclear explosions. Middletown, Palo Verde, Okuma... Pripyat... At this very moment, Central’s fuel was melting through its containment and slipping nearer and nearer the Newark Bay. Imagery haunted him of the different shapes various known corium flows had adopted in their pursuit of final rest. Slag swaths pouring ironically from water coolant release valves... Stalactites from falling through floodwater... The largest diamond in the world, formed through the sheer heat and density of a completely dry meltdown... He no longer dreaded the proximity to the disaster, instead transfixed.

“Hey, now, sleeping is just about the last thing I’d expect you to be doing right now.” Augen threw down two very large shopping bags on the end of the bed and rooted through one. He went into the bathroom with an armful. “Sorry I took so long. The line at the ShipShop kiosk was godawful.”

“Good morning to you, too.” ‘Choly grunted upright and finished off his cold coffee. “I was wondering where the hell you went. I didn’t mean to drift off, for what it’s worth.”

“I see the TV’s on. You saw the news, right?”

“I, yeah.” He glanced up at the screen to see emergency alerts still flooded the broadcasts. “Yeah, I didn’t think I dreamed that.”

“Slept well, then, I’m guessing?”

“As well as to be expected. Why were you asking about my sizing?” he started, looking slyly to the bags.

“You can root around and see for yourself. I’m going to help myself to your shampoo and stuff. As unnatural as it feels, I’m going to bathe twice in one week. Last night justifies it.”

One of the bags contained several boxes including a pair of shoes, while the other was a bunch of garments. He pulled out a few, and took off his tank to try on a few. A black tee stated a simple but gaudy ‘Sorry I’m late, I was masturbating.’ He scoffed, but, drawn to it, put it on immediately. He’d have said something, but the shower was already going, so he kept fishing in the clothes. Augen had brought him lacy black underwear, in both thong and bikini cut, and flustering he favored the latter for lack of another option. With the shirt he paired vein-print leggings. The shoes were low-heeled black boots, with pointed toes accented with a metallic tip. He returned them to the shoe box to pull out the other boxes in the bag. Several of them were carefully wrapped but otherwise unlabeled. Of those he could discern, he couldn’t really identify what they were.

“Figured you’d like that one the best.”

Augen came out in a white button-down and a pair of straight-leg black jeans, drying his hair.

“What, the shirt? You sure you didn’t get that for you?”

“A mirror, darkly. In these trying times, I took it upon myself to devise a new fashion capsule for you.” Augen flopped onto the bed to recline beside ‘Choly. “Zahnsammlung. You tend to emulate metahumans you fancy. I figure you could emulate me for a change.”

“Awfully presumptuous of you, to think I would,” ‘Choly feigned, laying back beside him eye to eye. “It’s been years since I emulated anyone besides myself... Tell me, what qualifications can you cite? To justify that degree of fixation?”

“Just how many demonstrations must I provide you, before you understand I’m the real deal?” Heavy-lidded, Augen played with ‘Choly’s bleached hair. “I’ve always thought this was a good look for you.”

“Have you ever...?”

“Bleached? Once. I thought it was too much trouble to do upkeep. How do you think Cecil will react to seeing you did your hair again?”

“He’ll think, that I think I’m guilty of everything that’s going on. And to some extent, he’s right. My brain tends to cope, badly, by accepting some or all of the blame for things I can’t have possibly done. But no, I guess I did it because even little expressions of self-control can anchor the chaos around a person.”

“Speaking of the chaos...” At Augen’s prompting ‘Choly flipped to be spooned, the vampire cuddled up to him and petted his hair. “Tell me, how you think it’s all going down, down there...”

‘Choly’s eyes rolled back, knowing exactly what buttons Augen set out to push.

“...Well, Central’s energy series is a ring of nine reactors...”

Go to Next »»»

[daniels09stuff]

DME Billing For Medicare Part B

With old age, assistance and assistive equipment become essential to help us do things that were natural to us once—for instance, a walker to move and walk around easily without a nurse. But for many older people, the world of insurance and vendors can be pretty overwhelming, mainly when it comes to purchasing Durable Medical Equipment (DME).

But the challenges of navigating the world of DME are not only for the end-users, i.e., the patients, but also for the DME service providers. The facility is different from any other services in the medical field, which makes DME billing and coding more challenging.

Since DME is given to patients to avail of the therapeutic benefits for certain health conditions or diseases, it is also used at the home, hospital, or other healthcare units regularly by the patients in many cases.

What are Standard DME Products?

Within the standard DME products, there are two parts, Part A and Part B, which include:

Cranes

Orthotics

Pressure Sleeves

Slings

Supports

Wheelchair

Despite becoming an essential requirement for the increasing aged population, DME billing is shrouded with lots of uncertainty. As a result, many DME service providers, despite having the proper doctor prescriptions for the services many DMEs struggle to reimburse the money for the services rendered.

Details about DME Billing for Medicare Part B

As mentioned earlier, DME billing is categorized into two parts, Part A and Part B. In Part B, there are certain restrictions on the coverage of medical supplies. The section offers the benefit of equipment to the patients medically necessary as prescribed by the physician. The equipment can be used at home, but the supply has to be prescribed and purchased from providers who belong to the Medicare program to get the benefit. Furthermore, the supplier also needs to accept and adhere to the DME Medicate regulations.

In most cases, for the Part B benefit plan, the patient has to pay 20% of the allocated amount under the Medicare allowance for the DME. But before that, the patient needs to meet the Part B applicable deductible amounts.

It is also important to note that the DME supplies or equipment can be subjected to competitive bidding in some regions of the country where a patient resides. Medicare introduces the process as part of a cost-saving initiative. It helps the healthcare costs align with the item’s actual purchasing price. If a patient has Medicare coverage that stands under the bidding program for DME, they must use a supplier contracted with the Medicare program. Failure to do so will result in the patient not getting the benefit from Medicare.

Which DME are included in Medicare Part B Plan?

Here is a list of the supplies and equipment that falls under Medicare Part B and can be reimbursed.

Commode chairs

Continuous Positive Airway Pressure (CPAP) along with its devices and related supplies to

equipment and supplies for Enteral nutrient

Hospital beds and their accessories

Standard nebulizer and its related supplies

Negative Pressure Wound Therapy (NPWT) along with pumps and related supplies

Oxygen, its equipment, and other related supplies

Patient Lifts

Seat lifts

Walkers

Wheelchair and its accessories for both manual and standard power

RADs (Respiratory assistant devices and the related supplies

Mobility scooter and the related accessories

Group 1 and Group 2 support surfaces

TENS (Transcutaneous Electrical Nerve Stimulation) devices

Diabetes testing supplies (mail-order only)

How is the DME Billing Done?

DME service providers should be extra careful and succinct with the DME billing and coding, regardless of whether they charge regularly or twice a year. A single error will lead to the loss of thousands of dollars for the service provider.

It has been observed that several DME organizations charge consistently across the financial year, and some facilities charge only a few times every year. While doctors might recommend a patient find a DME provider in their region, patients can choose a DME supplier of their preference.

What should DME do to Provide the Equipment?

Whether the DME equipment falls under Part A or Part B category, the DME suppliers should adhere to specific activities when providing the equipment to the patients. Some of them are:

Ensure proper and legitimate delivery of the equipment and setting it up for the patient

Check and ensure that the condition of the facility, e.g., home, hospital, clinic, or nursing home, is sheltered and has the optimum condition to warrant the best possible use of the equipment.

Train the patient, family, or caregiver to operate and use the equipment in the best possible way and upkeep it.

Giving the patient or the caregiver the necessary information on the usage and maintenance of the equipment.

All of these- all the DME suppliers and service providers have to give consent to the HIPPA (Health Insurance Portability and Accountability Act) to ensure all the documents and records of the patients are secured and cannot be accessed without the proper authorization.

How can DMEs with Part B Plan ensure Correct Billing?

The discussion on how DMEs lose money due to incorrect DME coding, adding modifiers, or failing to provide the required document has been a hot topic in the healthcare industry. Often the facility fails to give the necessary documents to support the equipment requirement, resulting in claim denials or rejections. While the DME service provider also has to check whether the patient is covered by Plan B to get the money, it becomes challenging to scrutinize every detail.

24/7 Medical Billing Services, your outsourced DME billing partner is your best choice for such an instance. As a DME billing and coding service provider, we ensure that the patient is covered by Plan B for DME and also follow up with the payers to ensure you do not lose the revenue. Our specialized DME billing experts provide support to all DME facilities with their billing and coding process and better RCM to warrant an improved ROI and better scalability.

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Medical Equipment Pharmacy Near Me

At Citizen Pharmacy and Medical Equipment, you could expect non-public attention provided through our caring, professional team of workers. Our expertly educated pharmacists and pleasant body of workers delight themselves on making sure your pharmacy enjoy exceeds expectancies. Visit us nowadays and let us take care of you.

Citizen  Pharmacy and Medical Equipment is a own family-owned unbiased pharmacy and durable medical gadget organization. We are pleased with our recognition for maintaining customer support our top priority. We can keep to provide the nice care and provider that Citizen Pharmacy and Medical Equipment customers have come to anticipate.

 Citizen Pharmacy and Medical Equipment employs over 17 humans for the pharmacy and DME areas. We provide continuing education to all employees to allow us to stay up to date on all aspects of the drugstore and durable clinical gadget business. We have personnel educated in billing Medicare, Medicaid, and maximum insurance plans. They are to be had every day to answer your questions concerning money owed and you can be assured that your privateness may be the utmost priority when discussing any claims or issues with Medical Equipment Pharmacy Near Me.

The pharmacy no longer simplest gives prescription medication however custom-made compounded prescriptions. Our pharmacists, as well as considered one of our CPhTs, are PCCA (Professional Compounding Centers of America) educated. Our pharmacy has 4 CPhTs (Certified Pharmacy Technician) and we encourage group of workers technicians to pursue this certification.

 Our DME has  licensed orthotic fitters and we've got a respiration therapist on team of workers to help with the setup and schooling of CPAP and BIPAP machines. Members of our staff have additionally been educated in maintenance of all products provided with Medical Equipment Pharmacy Near Me.

 We are also BOC accredited for domestic scientific equipment. Our mission is to exceed our patron's wishes in professionally supplying first-class products and services. We provide our personnel with a private and professionally profitable environment with a idea of teamwork. We agree with we are an imperative a part of the health care gadget and the markets that we serve. We function in a manner so one can offer reasonable boom and profitability ideal to our Board of Directors.

We are diagnosed by using Medicare to fulfill the house medical device needs of seniors

Our business enterprise meets all 30 Medicare Supplier Standards

Citizen Pharmacy and Medical Equipment has been supplying scientific services and products to the network for 22 years.

Citizen Pharmacy and Medical Equipment has a certified body of workers of 17.

Citizen Pharmacy and Medical Equipment has years of revel in healthcare, care giving, and meeting the needs of folks that need domestic medical gadget and services

Citizen Pharmacy and Medical Equipment requirements require every of our friends to receive 6 hours of persevering with schooling annually.

For more Information please visit-https://citizenspharmacy.com/

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Understanding The Complexity Of DME Billing

Understanding The Complexity Of DME Billing

Durable Medical Equipment (DME) billing  is one of the booming and extensive industries in today’s date. The industry is constantly evolving due to changes in compliance regulations and requirements. It can be a task if the providers don’t have an in-depth understanding, which may result in a larger number of rejected claims, lower reimbursement, and hence lower revenue.

What is DME?

DME is the medical equipment providing therapeutic benefits that can help people in need due to certain medical conditions, at home or any non-hospital setting. The DME must be medically necessary, requires a prescription, and needs to be authorized before it gets eligible for coverage. DME providers need to have a streamlined billing process for submitting and receiving claim payments from the insurance companies.

DMEPOS is a broader concept including SME medical equipment and Prosthetics, Orthotics, etc. DMEPOS equipment includes walkers, crutches, hospital beds, wheelchairs, artificial limbs, neck braces, prosthetic devices, and many more.

How is DME billing different?Things that make DME billing different from other types of medical billing:

Renting or owing equipment is allowed in DME billing and codes are specifically designated to equipment. Whereas codes are mostly designated to procedures or services in medical billing.

DME billing uses HCPCS (Healthcare Common Procedure Coding System) Level II codes while medical billing uses HCPCS Level I codes generally.

Modifiers are optional and won’t directly impact the claim in medical billing. Whereas the use of modifiers is mandatory and will determine if a claim will be denied or approved in DME billing.

Processes in DME Billing

The patient must have seen a specialist who has prescribed the equipment as essential. Hence, a written prescription from a medical practitioner is needed.

The patient will then go to a DME provider to get it. A Certificate of Medical Necessity should be completed and signed by the doctor and the DME provider. At this step, the patient also may need pre-authorization, which is done by the patient’s insurance company. A signed delivery slip or its photo can also be asked.

The provider contacts the insurance company to confirm and check information like which insurance the patient has and what all it covers. The patient’s insurance policy number and the group plan number are also taken.

Only after successful verification of the documents and information, the provider can generate the invoice. This is the step where each piece of the equipment is billed and coded according to the HCPCS Level II codes and modifiers. Some of the common modifiers used are RR – Rental, NU – Purchase of new equipment, UE – Purchase of used equipment.

The final step is to file the claim electronically. Claims sent to the insurance company will then be evaluated and the process may take around 30 days. If they’re rejected due to any reason, the provider needs to re-submit with corrections.

Tips for Better DME Billing

DME payor medical policies change frequently and you need to stay updated with all those to run your billing smoothly.

As common as it sounds, you need to have a thorough billing process from admission to submission of claims. It will ensure you get fewer denials and the maximum reimbursement for all your claims.

If you’re unsure about the documents needed, you could always confirm them first with the insurance company. As the DME billing process is exhaustive, one small error in the documentation can bring you to the start again.

Any patient’s record must display medical necessity always. You may check medical policies and Local Coverage Determinations (LCDs) to see what can be added as medical necessity proof.

Keep reviewing the denial rates and pay extra attention to the reasons why the claims were denied. You also need to correct the errors and re-submit them to take benefit of reimbursements.

Regularly audit your process so that all things are kept updated.

Outsourcing DME Billing Services can help reduce your stress as the appointed company will stay updated with the policies for you, submit all the claims, check and correct the HCPCS codes, and keep track of the rejected claims. Outsourcing saves your time and resources to develop a process, train staff with all the current regulations, and reduce your time-consuming tasks.

Info Hub is a leading offshore medical billing service provider agency and we can help you with optimizing costs for your DME billing services.

We will help in verifying eligibility, prior authorization if needed, correct use of HCPCS Level II Codes and Modifiers, submission of claims, accounts receivable and managing the denied claims.

Outsourcing DME Billing Services to India has several benefits as they’re thoroughly updated with the medical billing in the USA.

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CBS Medical Billing

Outsourcing in the medical field: The answer to keeping the industry afloat

 When we think of medical practice, the first thing that comes to mind is doctors. However, there is a whole team behind them that plays a big role in keeping the industry running. CBS Medical Billing and Consulting is a company that does this by providing full-service practice management and medical billing and compliance services for healthcare practices. They have years of experience in providing the best medical billing company orthotics and prosthetics services in the industry, and they specialize in solving difficult revenue and medical billing challenges, in order to stabilize and promote cash flow for all types of medical services.

 First of all, CBS provides several services, and they fall under three main categories. Revenue cycle management, practice management support, as well as medical billing services. An important feature they offer that falls under revenue cycle management is the weekly account review. It is highly recommended, and it consists of regular scheduled calls between your CBS account manager, and your office representative in order to discuss the best practices, and keep your profitability. The call will include discussing your accounts receivable, patient management, collections and compliance. They will even take a look at any claims that were denied, and what caused it.

 In addition, another important feature that falls under the practice management support category is administration. You will be assigned a CBS consultant who will administer accurate documentation, reporting and coding in order to streamline your accounts receivable and provide transparent and in depth support.

Furthermore, the last category ( which is medical billing services) is important, because of all the emergency and temporary situations that come up in the medical field. Some of the most common situations CBS deals with is:

 ●     Coverage for maternity leave

●     Coverage if another billing company quits

●     Coverage when an administrator quits

 Moreover,  there are many benefits to outsourcing your medical billing. For instance, it can significantly lower the costs of your business. It also takes the stress off your employees, and helps you focus on doing what’s most important, which is providing quality patient care. Another perk is that you will get improved transparency and control. This means that you will be able to review compiled information, and monitor the process at any time.

 Outsourcing can be the answer to keeping you and your company organized and working more efficiently. This company has a history of consistent communication and contact with their clients to ensure success. Contact CBS at 888-510-4416 today for more information.

                                                     Works Cited

 CBS

https://www.cbsmedicalbilling.com/revenue-cycle-management/weekly-account-review/ Accessed on November 10-11th. Hercules SEO. CBS Medical Billing & Consulting LLC.

 Med USA

https://medusarcm.com/blog/is-outsourcing-medical-billing-a-good-idea-the-data-say-it-is/  Is Outsourcing Medical Billing A Good Idea: The Data Says It Is. Accessed on November 11th. Med USA.

https://www.cbsmedicalbilling.com/

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https://www.facebook.com/CBSMedicalBilling https://twitter.com/CBS_Billing https://www.linkedin.com/company/cbs-medical-billing-&-consulting https://www.youtube.com/channel/UCQrk8fbocvCJOdJ9Z3V5Uiw