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Recent Medicare Compliance Inquiries

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Medicare Compliance

Coding for medicare reimbursement for substance abuse, mental health in california

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    Dawn |Partner

    Hi, More than willing to assist, do you have multiple questions? Dawn...

    14 Minutes Later
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    Evan |Consultant

    I am an expert working with Medicare mental health reimbursement. CA clients include *****, L...

    4.1 Hours Later
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    Judith |CEO

    My partner and I can help you on this, she does coding I do medicare, we both cross over... Please l...

    4.2 Hours Later
+9 Other Responses
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Medicare Compliance

We are seeking a consultant who is well-versed in medicare insurance compliance issues...We are a direct marketing agency who will be producing direct mail packages to acquire & retain members... The consultant would insure the accuracy of our materials, identify hipaa compliant printers, mail shops and call centers... We have worked with health insurers for over 12 years but lack in-depth knowledge of medicare-specific compliance issues...

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    Adriana |National Director

    Jacobus Consulting can provide timely resources for HIPAA Privacy, Security and Breach remediation. ...

    1.3 Hours Later
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    Steven |Consultant

    The type of business that you are conducting, indeed, presents a number of risks and vulnerabilities...

    1.4 Hours Later
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    Evan |Consultant

    Hi I am a Medicare consultant well versed in Medicare Compliance, HIPAA. Your project sounds very in...

    3.8 Hours Later
+17 Other Responses
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Medicare Advantage: Special Needs Plans Policy And Coding

Our company offers medicare advantage special needs plans to beneficiaries in 12 states in the us. We currently have a need for an expert medicare policy and coding consultant. Please let me know if you are interested in hearing more about this opportunity.

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    Joy |Slayer-In-Chief/Owner

    I would be extremely interested in hearing more about your needs so that we could discuss how my Med...

    3.8 Hours Later
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    Robert |Previous Regional VP, Director

    Sounds interesting and might be something I can help you with. What more can you tell me?...

    4 Hours Later
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    Michael |Principal

    Hello Slamarca- I possess experience in Medicare Advantage compliance gained as a Government Progra...

    4.6 Hours Later
+9 Other Responses
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Medicare Enrollment

I missed enrollment for medicare. My mother is 86 and my sister(with down's syndrome 55yr)live n a retirement center and her current supplemental insurance is not accepted at the center. We currently have essence insurancere. She lives in southern il. Are their any options for insurance coverage that would be acceptable at the retirement center. The facilite has rehab,alzimers units, short term stay facilities 24 hour care facilities. . there aren't any 5 star plans available in her area.

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    Tanisha |General Manager, NC/SC

    Unless they have Medicaid or a Special Election Period (they lost insurance coverage, lost job, got ...

    6.8 Hours Later
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    Erin |Partner

    I would need to know if you are referring to Medicare taking care of the assisted living fee, which ...

    8.4 Hours Later
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    Michelle |Nursing Home Administrator/Preceptor Eld

    The facility they live in can verify insurance. Also, insurance carriers should advertise the levels...

    9.8 Hours Later
+3 Other Responses
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Medicare Compliance

Looking for compliance officer with experience to consult on medicare request for self audit and voluntary refund. Our medicare carrier palmetto gba did a post payment review of cpt code ***** on six in-patients. Upon review of our records, we were denied payment because their audit said our dr's handwriting was not legible.Now we have received a letter from medicare asking us to do a self audit and voluntary refund. We are a 1 physician internal medicine/infect disease consultant practice located in san bernardino county california and would prefer someone local within driving distance. My name is elaine. Thank you.

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    Geneviève |President & CEO

    My column "From the Floor" is available in Working Nurse Magazine...

    3.1 Hours Later
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    Troy |CEO/Principal

    Elaine, my name is Troy and I am a Medicare Compliance Professional. I am experienced in the medic...

    19.9 Hours Later
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    Elaine |

    Troy-***** , please send me a Proposal by clicking on the Proposal button....

    22.2 Hours Later
+15 Other Responses
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Medicare

Problem faced by my 66 year old wife - the reset of the 100days of sub-acute care coverage under medicare when the covered person has had a trach and a g-tube since oct 2011 yet was out of medicare coverage for more than 4 months, being under nursing care, after using up her 100 days recovering from neurosurgery and now recovering from cancer.

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    Wise |President/Principal

    What ***** you & your wife *****??? Each ***** different....

    8.2 Hours Later
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    WALTER |

    We are both ***** NJ ...

    22.6 Hours Later
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    Suzanne |President

    I'm sorry to hear of this situation. If you're in the Houston area, I'm happy to help and have many...

    1 Day Later
+5 Other Responses
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Hipaa Compliance

Need to have manual for our office to show we are meeting all medicare compliance and security guidelines. Need to have evaluation of our office that we are compliant. We are psychiatry office

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    Thomas |Doctor

    Hi - I am an expert in HIPPA Compliance. I have *****A Compliance Manuals for every type of H...

    20 Minutes Later
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    Ciara |CEO & Founder

    I would love to assist your office with your compliance needs. As a healthcare business consultant, ...

    2 Hours Later
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    Gerry |CEO

    Thank you for your inquiry! This is exactly what we do! Please visit our website *****...

    3.8 Hours Later
+9 Other Responses
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Medicare Billing

Information is needed for new state of california medicare unit in the department of state hospitals. Need information in regards to claims, billing, processes, and coding. Our department is currently working on streamlining our billing for parts a, b and d. Looking for potential hire of a consultant.

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    Robert |Medical Director/Managed Care/Reimbursem

    This is pretty vague. I'm a physician with 25+ years of experience with CPT and ICD-9/10 coding and...

    6 Minutes Later
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    Troy |CEO/Principal

    I have 25+ years of experience in healthcare, chief nursing officer and I have ran a coding medical ...

    1 Hour Later
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    ronald |business development executive

    I have 20+ years of experience working within the Part B program....

    10.9 Hours Later
+8 Other Responses
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Medicare Compliance

I am involved in a fca claim against an acute care hospital involving medicare and medicaid issues-- 1) upcoding, 2) improper status changes for inpatient only procedures, and 3) violations of 3 day inpatient stay rules for transfer to snf facilities. The us attny reviewing the case has hired nurse practitioners to advise the us attny and i would like a medicare coding expert to weigh in and possibly serve as the chief plaintiff's expert in the case.

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    Raymond |CEO

    I am Raymond Cogen MD MBA and head a Medicare conuslting firm (Cogen Medicare Consultants). We do no...

    1.5 Hours Later
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    Dorothy |Revenue, Billing/Coding Consultant

    I can help. 23 years as Medicare specialist. still contract with QIO....

    4.7 Hours Later
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    Robin |CEO

    I received your inquiry. I am an *****r with background and experience in compliance, parti...

    8 Hours Later
+7 Other Responses
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Medicare Advantage Plans

My firm is working on a project looking into the use of 3rd party prospective risk assessment providers for medicare advantage plans and we are looking to speak with experts responsible for decision making surrounding medicare advantage plans and any choosing any outsourced vendors used for prospective or retrospective risk assessment in relation to medicare advantage members and plans. Please only respond to this inquiry if you can answer the following questions: • what is the current size of the market for risk scoring assessment services for medicare advantage members? Is there an optimal plan size for these types of services? How are these services are currently priced? • are there any emerging business models or regulatory changes that would change the current way that these services are provided? • how important do decision makers view these assessments? Who are the decision makers for vendor selection, what are the selection criteria, and what are retention dynamics in the marketplace? How likely are non-adopters to use prospective risk assessments in the future? • what is the competitive landscape like for risk scoring assessment providers? What plans are using what vendors? Is it possible to differentiate on any dimension other than price? Thank you.

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    Stephen |Chief Underwriting Officer

    Unfortunately, this opportunity falls just outside the realm of my expertise and I will decline to p...

    2.1 Hours Later
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    Michael |President & Actuary

    i am experienced as an actuary, consultant, broker, network contractor and reinsurer in Medicare. a...

    2.2 Hours Later
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    Robert |Consulting Actuary, Reinsurance Consulta

    Thanks for thinking of me, but I'm a Property and Casualty Actuary (FCAS) and not a Life and Health ...

    2.6 Hours Later
+28 Other Responses
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Medicare Risk Adjustment

Looking for medicare risk adjustment vendors & marketing experts

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    James |Exec VP

    Not my area of expertise...

    1.9 Hours Later
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    New |

    Thank you for letting me know!...

    2.2 Hours Later
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    Scott |Managing Partner

    Strong experience as a risk adjustment expert in the payer and vendor setting. Over 12 years workin...

    1.8 Days Later
+3 Other Responses
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Medicare Provider Enrollment

I need people who are credentialed to enroll providers into medicare (pecos and/or paper)

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    Scott |President and CEO, Division Manager, Mar

    I enrolled more than 2000 clients into Medicare Advantage Plans with Humana. Had *****nse *****...

    14 Minutes Later
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    ELIZABETH |Provider Enrollment Coordinator

    I have extensive experience enrolling hospitals, groups, individual physicians, NPs, nursing homes,...

    18 Minutes Later
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    Wanda |Reg. Director, VP, Ex. Director, Adminis

    I have had experience enrolling home health agencies as Medicare providers. I am very familiar with ...

    1.7 Hours Later
+8 Other Responses
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