Julie Appleton Email & Phone Number

Cincinnati, Oh, Us

Nashville, Tennessee, Us

Manage compliance auditors and compliance reviews for 1600 plus physicians.

Brentwood, Tn, Us

• Assist physicians and corporate staff in acquiring licensure, certificates, provider numbers, hiring staff, developing fee schedules, DEA numbers, outside services, select and install computer systems, develop medical record systems, establish supply inventory, purchase equipment and furniture, develop and implement marketing plan, coordinate or conduct staff training with personnel, clinical and operation responsibilities. • Works with Senior Directors to monitor compliance.• Develop timeline task list and checklist for start-up.• Develop the physician practice database, used for monitoring new physician start-ups and provider credentialing. • Assist in developing the coding compliance audit plan.• Perform system-wide audits to investigate and monitor compliance with standards and procedures required by Federal and State Laws throughout the 51 hospitals and physician clinics owned and operated by Lifepoint Hospitals, Inc.

Chicago, Il, Us

Us

• Performed system-wide audits for 425 dialysis facilities to verify that documentation in the patient's medical record supports the claim information submitted to Federal health care programs for reimbursement.• Tracked any overpayments by a Federal health care program are adjudicated in accordance with the procedures approved by the fiscal intermediary or carrier.• Compiled and report audit findings and company-wide trends to Vice President of Compliance.• Assisted with the investigation of any report alleging non-compliance with billing and reimbursement guidelines for federal health care programs.• Monitored Probe reviews and ADR’s from Medicare. Work with FI’s, facilities, and billing office to ensure identified opportunities handled appropriately.• Participated on the Electronic Health Record Workgroup to verify that the clinical systems support the applicable regulations related to billing and reimbursement for federal health care programs.

Nashville, Tn, Us

• Performed onsite system-wide audits to investigate and monitor compliance with standards and procedures required by Federal and State Laws throughout the hospital and physician clinics owned and operated in 23 states by HCA.• Conducted meetings with Office Managers, Regional Practice Managers, Chief Financial Officers, or Area Vice Presidents upon arrival at practice/facility to review the plan of action for the compliance review involving each clinic, physician, or other providers. Schedule an “exit interview” with all appropriate parties to establish guidelines and procedures and review recommended corrective and preventive actions.• Provided ongoing education and seminars designed to specifically promote an understanding of ICD-9, CPT, HCPCS coding and compliance issues and the consequences of non-compliance throughout the physician practices, outpatient hospital, and Ambulatory Surgery Centers.