New Medicare cards are being issued that replace social security numbers with MBI, Medicare Beneficiary Identifiers. See Medicare's alert on keeping these numbers private and secure.
By Mollie Frawley, R.N., FCA Help Desk Coordinator
Monday, 05 March 2018
Many
chiropractors in Florida have received a copy of a recent report from the
Office of Inspector General, U.S. Department of Health and Human
Services that calls for better controls to prevent fraud, waste and abuse
related to chiropractic services in Medicare.
This report is based on services between 2010 and 2014 and provides us
two important lessons.
The FCA has received confirmation from some members that they have received letters from FCSO requesting repayments on audited claims denied by Strategic Health Solutions (SHS). There has also been at least one notice of additional payments received on codes reported as under coded. There are no reports of the repayments including an extrapolation to all payments made in 2015.
This is VERY good news.
The positive is that there was no extrapolation. Most chiropractic physicians affected will be dealing with a couple thousand of dollars at most instead of tens or hundreds of thousands of dollars.
So what should those doctors who were audited do now?
Medicare is taking
steps to remove Social Security numbers from Medicare cards. CMS will start
mailing new cards to people with Medicare benefits in April 2018. All Medicare
cards will be replaced by April 2019.
Medicare is beginning the revalidation process again. If a practitioner or practice fails to respond timely to these requests they will be deactivated AND will not be able to bill Medicare or collect from the patient for services rendered while deactivated. Members are encouraged to alert their staff to look for any correspondence from Medicare or First Coast Service Options and respond urgently. Revalidations can be time consuming and frustrating. The financial impact could be significant, however, if not handled with urgency and importance. Continue reading for important links to help you revalidate with greater success.
First Coast Service Options, your Medicare Administrative Contractor (MAC) for the traditional Medicare program, would like to request your opinion of our service by taking the MAC Satisfaction Indicator (MSI) survey. Your feedback goes directly to the Centers for Medicare & Medicaid Services and helps us understand how we can better service you. This survey should only take about 10 minutes of your time and closes May 31.
Many doctors have been notified of a Medicare audit conducted by Strategic Health Solutions. Strategic Health Solutions has been contracted to perform and provide medical review functions of Medicare and Medicaid programs. Strategic Health is currently performing medical review of records through the project Y4P0434 for Chiropractic Services.
The FCA Help Desk has received several calls this week regarding a request for records from StrategicHealthSolutions, an audit contractor for CMS (Medicare). Please be aware of a potential request for records and do NOT ignore. The FCA Help Desk is gathering Information to assist our members in responding. If you wish to discuss this with Mollie Frawley, FCA Help Desk Coordinator, please email her at insurance@fcachiro.org with your best contact information AND your FCA member number or your Florida DC license number.
Read more for helpful steps to take if you receive an audit letter.
