tci ED Coding & Reimbursement Alert - 2012 Issue 4

Compliance Update: Bone Up on Your Regional ZPIC's Functions And Stay Out of Trouble

Do you understand how this extra layer of investigation fits in the overall program integrity picture?CMS is clearly delineating for ED providers and their billing agents the statutory mandate, mission, purpose and goals of the Zone Program Integrity Contractors (ZPICs) -- and if you're not up to speed, you're heading for audit troubles. The ZPICs replaced the entities known as the "Program Safeguard Contractors", says Ed Gaines, JD, CCP Chief Compliance Officer for Medical Management Professionals, Inc, in Greensboro, NC.The main focus of a ZPIC is detecting, preventing and referring potential cases of Medicare fraud, waste and/or...

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