In CMS
Sep 11th, 2018
The Centers for Medicare & Medicaid Services (CMS) knows there is a lot of administrative overhead when submitting medical claims for payment. To help you navigate through the red tape, CMS has created a “Administrative Simplification Basics Series,” where you can Sign up for Administrative Simplification email updates. The series helps the healthcare community use electronic ...
If the results of an April 2018 Office of Inspector (OIG) audit are any indication, claims for telehealth services are about to receive closer attention. Physicians and staff can best prepare for a potential claims review through awareness and education. Rising Claims Raise Payer Interest A total of $17.6 million in telehealth claims were paid ...
In Audit
Aug 9th, 2018
Answer six questions to provide a concise audit that is purposeful, corrective, and educational. You’ve reviewed the records and analyzed the results. Now, it’s time to prepare for what may be the most challenging aspect of the audit process: presenting the results in a way that makes sense and generates the change needed to ensure ...
In Audit
Aug 9th, 2018
Create a policy that addresses gray areas, optimizes results, and refines documentation. Performing internal provider documentation audits with follow-up education is a very important piece of a corporate compliance plan. The goal is to improve compliance with healthcare regulations, but the process also shows providers you are a valuable resource and improves the coder/provider relationship ...
In Audit
Aug 9th, 2018
Make a plan that is committed to preventing, correcting, and maintaining compliance. Compliance is more than a document outlining plans to meet generalized standards you heard about at a seminar. Compliance is about setting expectations for employees of ethical, proper behavior. It’s about: Demonstrating your organization’s commitment to “doing the right thing;” Designing a mechanism ...