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Surgical Complications Don’t Have to Be Complicated in New York City

AAPC’s Regional Conference in New York City (Aug. 19-21) is the place to be for everyone on the revenue management side of healthcare; it provides the latest education, networking, vendors, and opportunities to keep you ahead of other healthcare business professionals. If you are a medical coder, biller, or auditor you’ll find it’s a treasure trove of career resources ― […]

The post Surgical Complications Don’t Have to Be Complicated in New York City appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

New York Takes Steps to Combat Measles Outbreak

New York State Governor Andrew M. Cuomo signed legislation June 13 removing non-medical exemptions from school vaccination requirements for children. Religion is no longer a viable excuse for not immunizing children in the state. “The science is crystal clear: Vaccines are safe, effective and the best way to keep our children safe. This administration has […]

The post New York Takes Steps to Combat Measles Outbreak appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

New York Doctor Imprisoned For $30M Scheme

Dr. Ewald Antoine pleaded guilty to healthcare fraud, as well as several other crimes. According to the indictment, Dr. Antoine posed as the owner of two clinics in Brooklyn, falsely claiming he examined and treated hundreds of patients there.

Read Full Story Here!

The post New York Doctor Imprisoned For $ 30M Scheme appeared first on The Coding Network.

The Coding Network

Mount Sinai Seeking FULL TIME Coder with Experience; New York City

Revenue Cycle Operations is seeking to interview candidates for immediate hire for : FULL TIME Position as – Coder, with Experience.

Please see the attached Word Document for Employment Specifications.

Send all questions and submissions to
:

Jeffrey Gurkin-Young
Director of Revenue Cycle Operations and Patient Access.
Email: [email protected]

Attached Files

Medical Billing and Coding Forum

Better way to bill New York Medicaid.

I have been struggling to bill medicaid secondary due to it’s timely filing.
I have no trouble billing medicaid secondary when Medicare is primary because for some reasons they only recognize adjustment codes from Medicare ERA’s when done through our EMR, so all I have to do is click submit. This DOES NOT work when its from a Medicare DUAL ADVANTAGE PLAN. I’d get the "patient has other coverage denial" not recognizing that those adjustment codes are from that "other coverage." I’m forced to tediously enter the adjustment codes for each and every claim and all the demographic and primary insurance information on emedny epaces. It takes me about 5 minutes to do each claim, some times more because this method is so error prone. Although the medicaid manual requires you to bill them as secondary within 30 days of your control from the date of the primary E.O.B. they used to pay the claim if it’s done within 120 days so as long as you use "7" (delay due to primary) as your delay reason. Then without warning they changed it to 90, which caused me to scrap a whole month of claims. Just today without warning their system dropped it to 60 days so I had to scrap another 30 days worth of claims which is still 1000’s worth of claims. This is extremely unfair especially both times with no warning. We get like over 200 medicaid secondary claims a month. It’s impossible for a single biller to handle all this data entry per a medicaid claim. It’s just way too time consuming for the poor amount that they pay when I have to prioritize higher paying claims. But in large numbers it is a lot.

I wonder if I’m the only one struggling with this.

If there’s a better way, please let me know.

Medical Billing and Coding Forum

New York Doctor Sentenced To 13 Years In Prison For Multi-million Dollar Health Care Fraud

A New York surgeon who practiced at hospitals in Brooklyn and Long Island was sentenced today to 156  months in prison for his role in a scheme that involved the submission of millions of dollars in false and fraudulent claims to Medicare.

Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, U.S. Attorney Richard P. Donoghue of the Eastern District of New York, Assistant Director in Charge William F. Sweeney Jr. of the FBI’s New York Field Office and Special Agent in Charge Scott Lampert of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Office of Investigations made the announcement.

Syed Imran Ahmed M.D., 51, of Glen Head, New York, was sentenced by U.S. District Judge Dora L. Irizarry of the Eastern District of New York, who also ordered Ahmed to pay $ 7,266,008.95 in restitution, to forfeit $ 7,266,008.95, and to pay a $ 20,000 fine.  Ahmed was convicted in July 2016 after an 11-day trial of one count of health care fraud, three counts of making false statements related to health care matters and two counts of money laundering.

“Medicare is a crucial program for many of the most vulnerable people in our society – American seniors and those with disabilities,” said Acting Assistant Attorney General Cronan.  “In this case, Syed Ahmed put his own greed ahead of the trust we put in our medical professionals, draining over $ 7 million in precious funding from our Medicare program.  His conviction and the sentence imposed in this case demonstrate the Department of Justice’s unwavering commitment to protecting public funds and the integrity of our health care system.”

“Dr. Syed Ahmed treated Medicare like a personal piggy bank, stealing over $ 7.2 million by making fraudulent claims for medical procedures he never performed,” stated U.S. Attorney Donoghue.  “Dr. Ahmed will now pay the price for violating the trust that Medicare places in doctors.  His 13-year prison sentence and the heavy payments imposed should send a powerful message of deterrence to other medical professionals who would seek to defraud vital taxpayer-funded programs like Medicare for personal enrichment.  This Office, together with our law enforcement partners, will remain vigilant in rooting out health care fraud.”

“Health care fraud is often billed as a victimless crime, but that couldn’t be further from the truth,” said Assistant Director in Charge Sweeney.  “Someone is always left to foot the bill. Insurers, the insured, and others are the ones who pay the price. Those who employ these schemes will most certainly be brought to justice, as we’ve proven here today.”

“The fraud scheme that Dr. Ahmed engaged in was motivated by pure greed,” said Special Agent in Charge Lampert.  “HHS OIG and our law enforcement partners will continue to aggressively pursue all those who seek to unlawfully enrich themselves by victimizing participants of the Medicare program.”

According to evidence presented at trial, Ahmed, a surgeon who practiced at Kingsbrook Jewish Medical Center and Wyckoff Heights Medical Center in Brooklyn, Franklin Hospital in Valley Stream, and Mercy Medical Center in Rockville Centre, New York, billed the Medicare program for incision-and-drainage and wound debridement procedures that he did not perform.  Ahmed wrote out lists of phony surgeries and sent the lists to his billing company in Michigan with instructions that they be billed to Medicare.  Ahmed also directed that the surgeries be billed as though they had taken place in an operating room so as to increase the payout for the fraudulent scheme, the evidence showed.

The evidence introduced at trial showed that Medicare paid over $ 7 million to Ahmed for fraudulent claims.

The FBI and HHS-OIG investigated the case, which was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of New York.  Trial Attorney Debra Jaroslawicz of the Fraud Section, Assistant U.S. Attorney F. Turner Buford, formerly a Fraud Section trial attorney, and Senior Litigation Counsel Patricia Notopoulos of the Eastern District of New York are prosecuting the case.

The Fraud Section leads the Medicare Fraud Strike Force.  Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 3,500 defendants who have collectively billed the Medicare program for more than $ 12.5 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

The post New York Doctor Sentenced To 13 Years In Prison For Multi-million Dollar Health Care Fraud appeared first on The Coding Network.

The Coding Network

New york medicaid question!!

Hi , I really need some information here and I am hoping someone can help me. I want to know how does your company bill for Medical Necessary Contacts and the fitting. If you can either tell me or if I can call you to discuss, I work at a State Facility and we think they have been billing them wrong all along.

Thank you !

Laura

Medical Billing and Coding Forum

Medical Malpractice New York – Know the Facts!

The word Medical malpractice means failure of medical professionals to provide appropriate treatment or assistance to patients. The activity can be fatal in many cases, Medical malpractice occurs when a doctor, nurse, dentist or other medical healthcare worker performs his or her duties under negligence .This can be described in other term as an act of seer negligence in which the victim or the patient is affect negatively. These affect can be physical or mental and can influence the victim throughout his life.

Since 1970’s medical malpractice has been a controversial social malpractice issue due to non availability proper lawsuit. In recent decades, there has been a considerable development in field of medical malpractice cases due to awareness among general public and creation of New Laws. In New York particularly there has been a rise in the numbers of suit filed against the offenders and most of them were judged in favor of the victims.

If you are a resident of New York and you have faced any similar situation in past or in recent times, then you can take assistance of the medical Malpractice New York lawyers. It is highly recommended to hire experienced malpractice lawyer in case you are a victim. We should note that the most common medical Malpractice cases occurs when doctors usually do perform his duty to the recommended level or in general term we can say that it is performed under act of negligence. The other common cases of misdiagnosis occur when costly medical test result is overlooked or wrongly judged. For example, incorrect recommendation of prescribed drugs to the victim is one such instance. There can be many factors for medical professionals to execute such an error however most of them are due to human negligence. Under these conditions, it is easy to understand how so many fatal and injurious mistakes and errors occur in New York City.

We should always ensure that we take professionals help before filing a case against the offender. These help can be taken from experienced malpractice lawyer and to hire the malpractice lawyer one can take assistance from internet or local publication. The lawyers are nowadays easily available in New York City. The general citizens of the New York City are protected by highly victim centric laws. These laws are shaped keeping history of the victim in view and also the affect of the malpractice in long run. Other factor includes the effect of human error on the victim and his or her family. Some of the malpractice symptoms can be seen in the latter stage of life. The medical malpractice New York laws are intended keeping these factors in mind. So we can conclude to the point that regardless of the fact whether these affects of malpractice are spontaneous or not, the victim is certain to get suitable verdict in his favor. Generally, the victim of malpractice is eligible for monetary compensation; however the compensation amount may vary from case to case.

George Turner gives advice to clients who are looking for attorneys to handle injury related cases. To know more about the services of medical malpractice, medical malpractice lawyer new york, medical malpractice lawyers new york, medical malpractice law firm, personal injury New York, medical malpractice New York visit :   www.nbrlawfirm.com .

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