While standard insurance policies protect the doctor from most business risks, nobody offers protection against potentially enormous penalties in case of billing audit
Dumont, NJ (PRWEB) March 29, 2006
Jeffrey B. Randolph, Esq., has saved many practices from bankruptcy upon post-payment audit of their claims and billing procedures. “While standard insurance policies protect the doctor from most business risks, nobody offers protection against potentially enormous penalties in case of billing audit,” says Mr. Randolph, a partner at Labady and Randolph and legal counsel to the Association of New Jersey Chiropractors. “Monitoring billing compliance is doctor’s responsibility and ignoring it often results in practice ruin.”
Billing compliance monitoring is difficult because it requires testing of every claim against multiple rules. Additionally, major insurance firms use proprietary rules for selection of audit candidates. Over the years, Mr. Randolph has identified numerous rules that might trigger billing audit. Some tests are as simple as ensuring adequate claim documentation using SOAP notes, while others call for heavy-duty calculations, such as statistical pattern recognition, designed to identify an overused chiropractic manipulative treatment.
“Billing Precision utilizes specialized software to encode and leverage Mr. Randolph’s unique expertise,” says Dr. Yuval Lirov, inventor of several patents in artificial intelligence and computer security and author of “Mission Critical Systems Management” book. “Ensuring billing compliance in a high-volume practice would be impossible without high-performance systems.”
About Labady & Randolph:
Labady & Randolph, LLC, is a multi-state healthcare law firm specializing in insurance litigation, health care audits, arbitration of medical claims, billing and coding compliance, and professional licensure matters. Mr. Randolph is legal counsel to the Association of New Jersey Chiropractors, a member of the National Association of Chiropractic Attorneys, and is licensed to practice law in New York, New Jersey, U.S. District Courts for the 2nd and 3rd Circuits and the Court of Federal Claims.
About Billing Precision:
Billing Precision, LLC, is a national Third Party Billing Service, HIPAA compliant, Certified by New Jersey Department of Banking and Insurance, and a Business Partner of Association of New Jersey Chiropractors. Billing Precision consolidates billing services, tracks payer's performance from a single point of control, shares Medicare compliance rules globally, and creates massive economies of scale. It guarantees improved practice profitability and 100% transparency throughout the billing process. The service leverages comprehensive practice workflow technology, including patient scheduling, digital superbill, SOAP and SOAAP notes, and billing.
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