Apr 10th, 2019
Beginning this month, nine HIPAA-covered entities — a mix of health plans and clearinghouses — will be randomly selected by the Centers for Medicare & Medicaid Services (CMS) for compliance reviews. Any health plan or clearinghouse — not just those that work with Medicare or Medicaid — may be selected. The CMS Division of National ...
In Audit
May 17th, 2018
There has been a lot of focus recently on large fraud schemes uncovered by the government and many are wondering how this affects “me.” By Evelyn Kim, MBA, CFE, CPC, CPMA, CRC, AAPC Fellow Healthcare fraud is a thriving enterprise in the United States. The latest statistics from the Centers for Medicare & Medicaid Services ...
A focused effort on negotiating payer contracts can create much-needed money for any practice, and coders are uniquely qualified to facilitate these negotiations. This month, I’ll provide an overview of the contract negotiation process. In future months, we’ll discuss each step in greater detail to help you level the playing field with insurance companies. Ask ...