Program Integrity

Amenity supports The Center for Medicare & Medicaid Services (CMS) objectives of the Center for Program Integrity (CPI) promoting the integrity of Commercial and Medicare Plans audit and policy review programs. Amenity identifies and monitors program vulnerabilities and supports Plans, States and Administrators fighting fraud and abuse issues. Amenity collaborates with key stakeholders interested in program integrity activates that detect, investigate and refer fraud and abuse cases to the Office of the Inspector General (OIG) and or STOP claims payment before fraud, and or recovery claim payments from audit investigation work.

Amenity has Program Integrity Experience with Law Enforcement (DOJ, DHHS-OIG, MFCU)
CMS (ZPIC, PSC and MIC Algo) and State and Private/Managed Medicare and Mcaid and is able to provide a wide array of educational and training services:

• ICD-10
  • Coding Training
  • Operational Impact
  • Data & System impact
• Claims Processing
• DRG Audit Training
• Professional Coding/Billing Training
• Programming and Algorithm Development Advisory Services
• Specialty Coding/Billing
  • Injection & Infusion
  • Interventional Radiology
  • Other Specialty