Melanie G. Allen
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Melanie G. Allen, RHIT, CCS
Director and Senior Consultant
Audit Compliance Services
mallen@qmcg.com
phone 614.227.4852 |
Industry
Area of Expertise
Melanie has more than 20 years experience in an acute care
hospital with management responsibilities in health information
management, revenue cycle management, and coding education. Most
recently, she has worked on the RAC appeal process, specializing in
MS-DRG denials. In addition, she has experience in assisting health
care facilities in meeting regulatory requirements for billing and
coding. Melanie has also consulted with many health care entities
on various billing issues; worked with fiscal intermediaries to
obtain answers to various issues regarding billing and compliance;
and has worked with Southwestern Schools as a Medical Coding and
Billing instructor in their adult education program.
Areas of Specialization
- Recovery Audit Contractor (RAC) reviews to include medical
necessity audits, outpatient claim audits, and MS-DRG reviews
- Educational Programs for physicians/staff on the Recovery Audit
Contractor (RAC) program
- Bill audits to assure that the services billed are the services
documented in the medical record
- ICD-9-CM coding review and DRG review for hospitals (inpatient,
acute care, specialty hospitals), outpatient surgeries, outpatient
diagnostic testing and therapeutic services. Home health, hospice,
skilled nursing facilities bill reviews
- ICD-10 coding education for hospitals and physicians
- Educational in-services for physicians or hospital staff on
ICD-9-CM coding and diagnostic related groups (DRGs), as well as
Evaluation and Management coding
Presentations & Speeches
- 2012 OPPS Update
- RAC issues affecting acute care facilities and programs
- Clinical Documentation Improvement and RAC
- ICD-9 Coding Updates - Moving Toward ICD-10
- Basic Billing and Coding for Physicians
- Hospital Acquired Conditions and Patient Safety Indicators
- Present on Admission Indicators
- Back to Basics - A Coding Review
Education
- Hocking College
- Ohio Dominican University, currently pursuing a degree in
cross-disciplinary studies
- American Health Information Management Association
Accreditation
- Registered Health Information Technician
- Certified Coding Specialist
- AHIMA Approved ICD-10 Trainer
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