Darren Carter, MD, President and CEO of Provistas, offers his insights and expertise to the Medicare provider community through Dr. Carter’s Corner, a resource for coding and compliance information. Dr. Carter’s Corner includes articles, tips, and frequently asked questions (FAQs) to help understand important ongoing changes to the Medicare program. Special attention is focused on Medicare medical necessity and local medical review policy (LMRP) changes.

Besides reading articles and tips posted here, you can subscribe to Dr. Carter's Corner in email form by the clicking here and selecting Dr. Carter's Corner as one of your interests.

Dr. Carter’s Curriculum Vitae

Education and Training
Research Fellow, HIV Behavioral Studies, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York, NY, 1998-2000
MPH (18 credits; fellowship lost scholarship funding), Columbia University, Mailman School of Public Health, New York, NY, 1998-1999
Internship, Center for Family Medicine, Columbia-Presbyterian Hospital, New York, NY, 1997-1998
MD, University of Chicago, Pritzker School of Medicine, Chicago, IL, 1997
BSc Biology, University of North Dakota, Grand Forks, ND, 1992

Appointments and Licensure
Assistant Clinical Professor, Department of Psychiatry, Columbia University, New York, NY, 2000-present
New York State Medical License, #211748, 1998

Editorial Boards
Briefings on Coding Compliance Strategies, Opus Communications, May 2001-present
Ambulatory Coding and Payment Report, Coding Institute/HFMA, Aug 2001-present
Part A Insider, Coding Institute/HFMA, Sep 2001-present

Presentations

Carter D, “Clinical and Payment Aspects of Medicare Medical Necessity,” West Virginia Hospital Association, Bridgeport, WV, May 9, 2003. http://www.wvha.org/education/Brochure/2003/may9brochure.pdf
Carter D, ”Necessity or Necessary: Clinical and Payment Aspects of Medicare Medical Necessity,” Rochester Regional Health Care Association, Rochester, NY, January 14, 2003.
Carter D, “HIPAA Privacy Regulations for the Healthcare Provider’s Office”, Southern New Jersey Dental Society, December 18, 2002.
Carter D, ”Necessity or Necessary: Clinical and Payment Aspects of Medicare Medical Necessity,” New Jersey Hospital Association, Princeton Junction, New Jersey, December 2, 2002.
Carter D, “Addressing Medicare Medical Necessity,” Association of Professional Coders, Regional Meeting, Philadelphia, PA, November 4, 2002.
Carter D, “Addressing Medicare Medical Necessity,” Association of Professional Coders, Regional Meeting, Indianapolis, IN, October 23, 2002.
Carter D, Goebel T, “Medical Necessities and ABNs,” Northwest Medical Laboratory Symposium, Portland, OR, Oct 18-22, 2002.
Carter D, Buck S, “Medical Necessity Solutions: How to Maximize Compliance and Improve Reimbursement,” HCPro audio conference, October 15, 2002.
Carter D, “Addressing Medicare Medical Necessity,” Association of Professional Coders, Regional Meeting, Scottsdale, AZ, October 11, 2002.
Carter D, “Medical Necessity for Hospitals,” AAHAM Annual National Institute, JW Marriott Hotel, Houston, TX, October 10, 2002.
Carter D, “Medical Necessity for Hospitals,” AHIMA, National Convention, Moscone Convention Center, San Francisco, CA, September 24, 2002.
Carter D, “Addressing Medicare Medical Necessity,” Association of Professional Coders, National Meeting, San Francisco, CA, September 21, 2002.
Carter D, ” Necessity or Necessary: Clinical and Payment Aspects of Medicare Medical Necessity,” North Dakota Healthcare Association, Bismarck, ND, July 31, 2002.
Carter D, ” Necessity or Necessary: Clinical and Payment Aspects of Medicare Medical Necessity,” New Jersey Hospital Association, Princeton Junction, New Jersey, July 18, 2002.
Carter D, “Medicare Medical Necessity: Problems & Solutions”, NYHIMA Annual Meeting, Hyatt Regency Hotel and Riverside Convention Center, Rochester, NY, June 26, 2002.
Carter D, “Managing Medical Necessity at your Hospital,” Long Island Health Information Management Association, Nassau-Suffolk Hospital Council, Islandia, NY, June 5, 2002.
Carter D, “Medical Necessity for Hospitals,” Five New England State Health Information Management Association Annual Meeting, Newport, RI, May 10, 2002.
Carter D, Barrie M, “Medical Necessity Compliance: Avoiding Denials,” HCPro audio conference, Nov 14, 2001, http://www.hcmarketplace.com/prod/showdetl.cfm?did=6&product_id=10789
Carter D, “Medical Necessity Solutions for MEDITECH Hospital Systems”, Medical Users Software Exchange (MUSE) 1 Regional Meeting, Springfield, MA, Sep 11, 2001.
Carter D, “Comply and Get Paid!”, Cerner Health Conference, Kansas City, MO, Sep 12, 2001. Cancelled.
Carter D, “Medicare Claims Edits in the Hospital Outpatient Setting,” MUSE International 2001, Anaheim, California, May 4, 2001.