Medicare Program Audit – Tracer Preparation Recently, in the Centers for Medicare & Medicaid Services (CMS) National Audit Training sessions which were conducted in August, 2021, Tracer Requirements were addressed. What is a Tracer? Per the current CMS Program...
Preparing for Your CPE Audit by: Sarah Lorance Segal Medicare Experts Senior Vice President It’s never too early to prepare your organization for an audit, especially a Centers for Medicare and Medicaid Services (CMS) Compliance Program Effectiveness (CPE) audit....
Best-Kept Secret – Free FWA Medicare Resource By Shelley Segal, CEO Are you a small to medium Medicare Advantage health plan struggling to identify fraud, waste or abuse (FWA) leads? Want help identifying patterns in your claims data to facilitate regular...
CMS 2022 Readiness Checklist – A Must for All Sponsors (MAs, PDPs, and MMPs) Written by Connie Snyder. CMS Released 2022 Readiness Checklist with a Stern Call for Immediate Action The Centers for Medicare & Medicaid Services (CMS) released the 2022 Readiness...
Score High with Polished Policies – Win the Favor of CMS Auditors Is your Medicare Advantage health plan still in the early-to-mid stages of building a Special Investigations Unit (SIU)? Are you struggling to write program policies and procedures (P&Ps), or...
Medical Identity Theft What is it and How Does it Happen? By Connie Snyder. Within the context of health care, identity theft may be defined as an incident in which a beneficiary’s personal identity and/or insurance information has been (unlawfully) obtained (by an...
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