Having your cake and eating it, too: the permissibility of provider-site information requests to be used in contractor-site reviews.
The December 2007 issue of "Tennessee Medicine" contained an article by Melaine Hill entitled "AdvanceMed Onsite Reviews: What to Expect." That article provides a valuable description of AdvanceMed's procedures in conducting post-payment reviews; however, it does not address the question, raised by many Tennessee physicians, whether those procedures comply fully with those specified by the Medicare Integrity Program. The following article examines critically some of the procedures employed by AdvanceMed in conducting post-payment reviews, points out apparent inconsistencies between some of AdvanceMed's procedures and those specified by the Medicare Integrity Program, and suggests possible responses. It is hoped AdvanceMed will respond to the specific issues addressed in the following article in a subsequent issue.
Voigt
John R
JR
Sherrard & Roe PLC, USA.
Ison
Mark A
MA
D022126:Access to Information; D014487:Centers for Medicare and Medicaid Services, U.S.; D006801:Humans; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence*; D020416:Outsourced Services; D011216:Practice Management, Medical; D013714:Tennessee; D014481:United States