Michael Reidlinger Email & Phone Number

Analyze and evaluate Prime Time Medical’s Medicare and Medicaid claims to ensure medical necessity prior to submitting for payment. Overpayments associated with lack of medical documentation have decreased by 25%. Successfully managed three company reaccreditations; each successive accreditation scored higher than the previous one. Currently managing the audit for 300 charts that were pulled by the Recovery Audit contract (Connelly Health Care Services). Interact with Florida’s Agency for… Show more Analyze and evaluate Prime Time Medical’s Medicare and Medicaid claims to ensure medical necessity prior to submitting for payment. Overpayments associated with lack of medical documentation have decreased by 25%. Successfully managed three company reaccreditations; each successive accreditation scored higher than the previous one. Currently managing the audit for 300 charts that were pulled by the Recovery Audit contract (Connelly Health Care Services). Interact with Florida’s Agency for Health Care Administration (AHCA) in ensuring compliance with State requirements for controlled substances such as dispensing oxygen. Interact with Medicare offices to research requirements, determine medical necessity, and respond to audits. Conduct and respond to company audits to ensure compliance with all federal, state, Medicare, and Medicaid regulations. Show less

Conducted internal audits to ensure company compliance with all government and Medicare regulations. This involved responding to audits from Medicare, Managed Care Agencies, and private insurance companies. Managed the audits, compliance issues, accreditations, and liability insurance for 500 offices throughout the United States. Project Manager for numerous special projects established to improve quality and validate compliancy with local, state, and federal institutions. The department… Show more Conducted internal audits to ensure company compliance with all government and Medicare regulations. This involved responding to audits from Medicare, Managed Care Agencies, and private insurance companies. Managed the audits, compliance issues, accreditations, and liability insurance for 500 offices throughout the United States. Project Manager for numerous special projects established to improve quality and validate compliancy with local, state, and federal institutions. The department reduced overpayments by at least 50% for the majority of audits. Lincare was under a 5-year corporate integrity agreement with the Office of Inspector General which required achieving stringent standards on each audit. The processes and procedures put into place achieved the standards within the compliance agreement and resulted in successfully closing the agreement at the end of the five years. Show less