Welp EKRA finally got enforced

[anonymous]

https://www.justice.gov/opa/pr/texa...legations-kickbacks-third-party-marketers-and

Related fuck them and it was fun while it lasted.

It had to be the dumbest lab in the game. Fuck off Jay.

 

[anonymous]

Does anyone know what happened to the reps or rep groups? if anything

 

[anonymous]

if you noticed in the article very clearly states they were taking toxicology samples without medical necessity. That means no progress notes to back up what the DX codes were marked. I know many labs are still allowing this even for molecular and they will be audited. It may not be this month but all labs get audited. You fail to provide the medical necessity the lab is required to have that information when billing. Also to note, Medicare pays first then asks questions later (Trust then verify method). With all being said, of course they came down on them with this violation. Conclusion...there is NO short cuts to the lab. Follow what is required and rules and do not assume.

 

[anonymous]

if you noticed in the article very clearly states they were taking toxicology samples without medical necessity. That means no progress notes to back up what the DX codes were marked. I know many labs are still allowing this even for molecular and they will be audited. It may not be this month but all labs get audited. You fail to provide the medical necessity the lab is required to have that information when billing. Also to note, Medicare pays first then asks questions later (Trust then verify method). With all being said, of course they came down on them with this violation. Conclusion...there is NO short cuts to the lab. Follow what is required and rules and do not assume.

Nah. Medical Necessity is not the key issue here. It’s only a consequence of the innate compliance nightmare- the void of oversight of the 1099 template. The key takeaway is, if you want a quick million dollars, land a role as a billing person in literally any small toxicology lab.

 

[anonymous]

Nah. Medical Necessity is not the key issue here. It’s only a consequence of the innate compliance nightmare- the void of oversight of the 1099 template. The key takeaway is, if you want a quick million dollars, land a role as a billing person in literally any small toxicology lab.

I worked there and the co was a chick the owner was fucking. Liz’s intelligence is about any random rock you see. Hire the dumbest people get the dumbest outcome.

 

[anonymous]

Nah...Read the article again. Clearly the biller was billing the samples without having proper documentation to ensure it was medical necessity. If you do not know how this works then ask. Majority of labs use a third party biller. The billing company takes what they receive and bill. I am 100% confident this lab, like many, did not request progress notes to confirm the DX codes that were used. I am 100% confident that there was Never an actual order placed for each sample in the note for date of service. I am 100% confident that 100% of those claims had the exact same DX codes. I am 100% confident that the provider most likely did not sign each requisition form or at best used a stamp.

 

[anonymous]

Oh this fucking loser will get his.

He is a fucking rat and will be taken care of.

 

[anonymous]

EKRA was not enforced here. Is was AKS idiot!