Episode 374 - Monday Auditing, Coding and Compliance Roundtable

Summary In this conversation, the panel discusses various challenges in the healthcare industry, focusing on the roles of students in medical practices, the complexities of Medicaid, and the implications of proposed CMS regulations on skin substitutes. They emphasize the importance of compliance, accurate documentation, and the need for providers to be aware of the evolving landscape of healthcare regulations and billing practices.TakeawaysStudents cannot perform or do any work that is billable and reimbursable.Documentation is key to halting audits and investigations.Medicaid faces challenges with enrollment and funding.Providers must understand the billing rules for students and graduates.AI can lead to cloning in documentation if not used carefully.Vendors must be held accountable for their products and claims.The EMR is a tool that requires proper management and understanding.Medicaid managed care plans can be poorly managed and lead to issues.Providers need to be cautious of schemes in billing practices.Skin substitutes are becoming a focal point for compliance and billing scrutiny.