Lilesparker.com

Changing Laws on Third Party Billing & Percentage Based Model

WEBExplore how changes in health care laws and regulations have impacted third-party billing contracts and percentage-based billing in the medical industry. Learn …

Actived: Just Now

URL: https://www.lilesparker.com/2022/07/29/changes-in-federal-state-law-and-billing-contracts/

A UPIC Audit is Serious Business

WEBLiles Parker attorneys are experienced health care lawyers with decades of experience representing Medicare and Medicaid providers in connection with claims …

Category: Health Go Health

Private Insurance Overpayment & Patient Credit Balance …

WEBNATIONWIDE REPRESENTATION — CALL 1 (800) 475-1906. The experienced health lawyers at Liles Parker can assist you assessing your obligations …

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Eight Elements of a Payable Medical Claim

WEBGenerally, we refer to this process as the “Eight Elements of a Payable Medical Claim. ” As set out below, non-hospital health care providers can often use this …

Category: Medical Go Health

Overpayment Considerations When You Owe Monies to Medicare …

WEBIII. Impact of the the Affordable Care Act (ACA) on Overpayments. The ACA was enacted in 2010. In addition to fundamentally changing the way people are insured …

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What is a Medicare Suspension of Payment Action

WEBMedicare Suspensions of Payment Based on Credible Allegations of Fraud. The ACA expanded the ability of the government to detect health care fraud and protect the …

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Michael Cook Lawyer Liles Parker PLLC

WEBMichael Cook is a Partner and Co-chair of the Health Care Group at Liles Parker PLLC and has represented health care related clients full-time for more than 41 years. Before that, …

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Liles Parker – Nationwide Healthcare Lawyers

WEBFor assistance in responding to a claims audit, a False Claims Act matter or a possible criminal violation, give us a call to schedule a complimentary consultation. We can be …

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The Changing Definition of Medical Necessity

WEBIV. The American Medical Association's Definition of Medical Necessity: The American Medical Association (AMA) defines medical necessity as: “Health care …

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TPE Audit Program and its impact on medical providers

WEB(January 26, 2023): Since the inception of the pilot program in 2015, the Targeted Probe and Educate Audit (TPE audit) program has effectively been a double-edged sword for …

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Preparing for a UPIC Audit

WEBA discussion of the eight elements which must be carefully assessed for each and every claim is provided below. This is especially when you are preparing for a UPIC …

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Home Health Services: Face to Face Encounter & Documentation

WEBProvider must perform a face to face encounter with patient, document and certify eligible beneficiary for home health services. Free consultation of expert civil & …

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Zone Program Integrity Contractor (ZPIC) Investigations and Audits

WEB(Updated January 4, 2021): In April 2014, the Centers for Medicare and Medicaid Services (CMS) issued an an Umbrella Statement of Work for the the awarding of program …

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Revocation of Medicare Billing Privileges for Home Health Agencies

WEBII. Primary Reasons Cited in Home Health Revocation Actions. In reviewing the 22 reasons that CMS may revoke a home health agency’s enrollment and Medicare …

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HIPAA: Restrict Patient Privacy, Diagnoses & PHI from Insurance

WEBI. Patient Requests to Restrict the Submission of PHI to Insurance: Under Section 164.522(a), a covered entity must permit individuals to request that it restrict …

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Effect of Inflation Reduction Act on healthcare providers-LilesParker

WEB(March 30, 2023): On August 16, 2022, [1] President Biden signed the Inflation Reduction Act (IRA) into law, bringing with it plans for broad sweeping changes to tax rates, energy …

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Overview of the HHS Departmental Appeals Board

WEBI. History of the Departmental Appeals Board: While in its earlier incarnation as the Department of Health, Education and Welfare (HEW), the Secretary, HEW first …

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Opioid & High Risk Drugs Audits on Pain Management Physicians

WEBThe health law firm Liles Parker represents pain management physicians and practices around the country in connection with ZPIC / UPIC audits. Opioid audits …

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HHS-ONC Names EHR Certification Bodies

WEB(September 1, 2010): Earlier this week, the Office of the National Coordinator for Health Information Technology (ONC), an organization within the Office of the Secretary of the …

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