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Issue #5 - January 16, 2013

Auditing/Compliance Tips and Resources

Avoid HIPAA Sanctions with Security Policies and Procedures

If you think your health care organization is immune to financial penalties following a violation of the Health Insurance Portability and Accountability Act (HIPAA), think again. Today, with the use of mobile phones, laptops, and other portable storage devices—more than ever—you need policies and procedures to safeguard private patient information, no matter how it's used or accessed.

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Don’t Let Medicare Revalidation Requirements Stop Cash-flow
By Delly E. Parham, AS, CPC

When Medicare requests your provider to certify the accuracy of his or her existing enrollment information with Medicare revalidation, comply in a timely manner. If you don’t, you may lose Medicare billing privileges or disrupt reimbursement.

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Use E/M Benchmarking to Assess Your Audit Risk
By Stacy Harper, JD, MHSA, CPC

In the current regulatory environment, physicians are searching for ways to minimize audit exposure. One way to do this is by understanding your use of CPT® codes prone to audit review. For example, Medicare administrative contractors (MACs) frequently review high-level evaluation and management (E/M) services. Providers with high use of targeted E/M codes are more likely to be audited.

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In This Issue
Avoid HIPAA Sanctions
Medicare Revalidation
E/M Benchmarking

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CPT copyright 2012 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. The responsibility for the content of any “National Correct Coding Policy” included in this product is with the Centers for Medicare and Medicaid Services and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, nonuse or interpretation of information contained in this product.