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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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URL: https://www.lilesparker.com/private-insurance-overpayment-patient-credit-balance/

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 …

Category: Health Go Health

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

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 …

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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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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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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 audits and …

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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 …

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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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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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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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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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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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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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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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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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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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Maryland Limits on Opioid Prescriptions

WEBOn May 25, 2017, Maryland Governor Larry Hogan, signed-off on "The Prescriber Limits of 2017". The legislation was enacted as an emergency measure and …

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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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