Get an insider’s view into insurance payments and denials and healthcare reimbursements. By Michael Strong, MSHCA, MBA, CPC, CEMC and Tracy Hunt, CPC, CFE Billers, coders, revenue cycle management, and providers often think of insurance carriers as the “big bad wolf.” Having worked for several insurance carriers, we’ve repeatedly heard accusations from providers and their ...
In Audit
Jul 1st, 2016
To help prompt more informed decisions about care delivery and quality improvement, the Centers for Medicare & Medicaid Services (CMS) finalized new rules allowing the sharing of analyses and data between providers, employers, and others. Data Rules in New Rules CMS said, “The rules seek to enhance the current qualified entity program to allow innovative ...
Part 3: Occupational Safety and Health Administration (OSHA) Act By Marcia L. Brauchler, MPH, CMPE, CPC, COC, CPC-I, CPHQ OSHA requires employers to provide a safe workplace for employees, and grants employees with the right to working conditions free from risk of serious harm. The burden of compliance depends on the industry you’re in. Mining, ...
View reporting as an improvement to your compliance process, potentially saving you hefty fines. By Erica Lindsay, PharmD, MBA, JD Employees are key resources for identifying and reporting compliance and ethics violations in your organization. Encourage and support reporting options for employees, including self-disclosure and anonymous reporting. The sooner a violation is identified and resolved, ...
The first step to ensuring your patients’ ePHI is secure is assessing your office’s HIPAA compliance. By Joette Derricks, MPA, CMPE, CPC, CHC, CSSGB Prior to the HIPAA Security Rule, a generally accepted set of security standards to govern electronic protected health information (ePHI) didn’t exist. Today, all covered entities, including small health plans, are ...