Monitor Mondays

Forensic Audits: Spurious or Genuine? Part II


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Reaction to the reporting here on forensic audits continues to reverberate. During last week's Monitor Mondays broadcast, Amanda Gilliland, a revenue integrity nurse auditor at UW Health in Madison, Wisc., reported on her experience and efforts to appeal what she describes as "spurious" denials. As reported last Monday, these denials are for commonly billed services and items such as IV solutions, supplies, point-of-care (POC) labs, venipuncture, respiratory therapy services, etc.

Michael Lewis, president of Financial Review Services of Houston, Tex. continues our reporting on this topic during this episode.

The episode rundown also includes:

  • Monday Focus: Analytics: Apropos of the lead story on forensic audits, senior healthcare analyst Frank Cohen, director of business intelligence and analytics for DoctorsManagement, returns to the broadcast to report on the use of analytics to determine outliers.

  • The Roche Report: RACmonitor investigative reporter and New York attorney Edward Roche returns to the broadcast with another one of his intriguing reports on an under-reported healthcare issue.

  • Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on problematic issues facing providers.

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, makes his Monday Rounds with another installment of his popular segment. Dr. Hirsch also reports on how to bill for inpatient services when there is no admission order.


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