Quadax is fully committed to maintaining compliance with all state and federal regulations, and we have established systems and practices to accomplish that goal. Our A/R Services business lines, including HARP and Revenue Cycle Management, incorporate these and other compliance strategies:
- Editing for duplicate claims for Medicare Part A
- Editing claims according to the Correct Coding Initiative for pairs of services that should not be billed on the same claim because they are mutually exclusive or comprehensive/ component (Column 1/ Column 2) services
- Ensuring that valid ICD-9 © diagnosis codes, CPT© Codes, and HCPCS are provided by the billing source for each test and are included on all Medicare claims.
- Checking procedure/diagnosis code combinations on claims for medical necessity according to LCD/NCD policies and supporting Advanced Beneficiary Notifications (ABNs)
- Enforcing the Medicare three-day payment window rule before a claim gets into the system. For HARP users, reports are generated so that these charges can be posted to the patient's inpatient account in the hospital billing system.
- Reviewing Medicare newsletters to identify all policy, procedure, and system changes that are required to conform to CMS billing standards and mandates. An insurance committee meets monthly to conduct the review.
Our Corporate Compliance program follows the OIG plan for third-party medical billing companies.