Monitoring                         

Departmental Cumulative Pre-Billing Transaction Reviews

Department Date Transaction Reviews       Anesthesiology Aug-97 All professional charges       Dermatology Feb-98 All surgical operative reports   Feb-98 Random sample of outpatient E&M charges per month   Dec-00 All In-patient E&M services       Emergency Medicine   All professional charges       Harlem Faculty Practice Jan-98 All in-patient Medicare services   Feb-98 All surgical operative reports, regardless of payer   Jan-99 Random sample review of Medicaid out-patient charges   Oct-00 Random sample review of Medicaid out-patient charges   Sep-00 All obstetrical services regardless of payer       Medicine Aug-97 MICU charges   May-98 All procedures in the Division of Digestive and Liver Diseases   Sep-99 In-patient Medicare charges submitted to the Physician Billing Office.   Sep-99 Procedures in Pulmonary, MICU, and random sample in Cardiology.   Sep-99 Monthly random sample of charges from Contract Physicians   Jul-00 Random sample review of procedures in Cardiology and ICU at Allen Pavilion       Neurology Mar-98 All out-patient Level 4 and 5 E&M charges   Jul-98 All in-patient E&M charges   Sep-99 Random sample of procedures per physician each quarter       Neurosurgery Feb-98 All surgical operative reports   Sep-99 All professional services       Obstetrics and Gynecology Feb-98 All surgical operative reports   Mar-98 All in-patient E&M and procedures       Ophthalmology Feb-98 All surgical operative reports   Sep-99 All in-patient E&M services   Aug-00 Random sample reviews outpatient E&M services and outpatient procedures per physician each month       Oral and Maxillofacial Surgery Feb-98 All surgical operative reports   Sep-99 All E&M services       Orthopedic Surgery Feb-98 All surgical operative reports   Jul-98 Monthly random review of out-patient E&M services       Otolaryngology Feb-98 All surgical operative reports   Jul-99 All in-patient E&M services   Sep-00 a) Random sample review of minimum of 25 outpatient E&M services     b) Five procedures per physician per quarter     c) Random sample review of Audiology services per quarter.       Pathology Jul-99 Monthly random selection of post payment charge reviews from all divisions       Pediatrics Mar-98 All E&M services Division of Hematology   Jul-98 All in-patient E&M services: Divisions of Pulmonary and Infectious Disease   Aug-98 All E&M services: Dr. Barst   Dec-98 All in-patient E&M services: DR. J.Levy   Oct-99 All in-patient services: PICU, Neprohology, endoscopies, and Cardiology random selection concentrating on Medicaid and Medicare charges   Oct-99 Random reviews of in-patient charges from other     clinical divisions, concentrating on Medicare and Medicaid charges   Dec-00 Random reviews of in-patient charges from     Cardiology Gastroenterology/Nutrition,and Nephrology   Apr-01 Pre- billing reviews for the Department of Pediatrics April 9,2001.     1. All E&M services provided by Dr. Robin Barst, regardless of the site of service, are to be reviewed.     2. Impatient services, concentrating on Medicare and Medicaid charges, for:     Cardiology Nephrology Hematology GI/Nutrition GPGP Genetics Oncology Perinatolog Pulmonary Rheumatology       Psychiatry May-98 All in-patient services   Mar-00 In-patient procedures       Radiation Oncology Jan-99 All in-patient and level 4 and 5 office E&M services   Sep-99 All E&M services   Oct-00 Monthly random selection of procedures       Radiology Sep-98 All E&M services   Sep-99 Selected random review of high complex in-patient services   Apr-02 Abstraction, and quality assurance reviews, of all Neurointerventional Radiology procedures, prior to billing.     Abstraction, and quality assurance reviews, of all Vasculiar Interventional Radiology procedures, prior to billing.     Abstraction of all diagnostic radiology procedures, with 1% of these services reviewed for quality assurance, prior to billing.     Quarterly random sampling of East Side Radiology procedures, prior to billing.       Rehabilitative Medicine Apr-99 All in-patient E&M services       Surgery Feb-98 All surgical operative reports   Jul-98 All in-patient E&M services       Urology Feb-98 All surgical operative reports   Jul-98 Monthly random review of office E&M services   Jul-99 All in-patient E&M services