Your journey to becoming a successful consultant has already begun. Often, while working with providers, coders, and billers throughout the United States, I am asked, “How can I do what you do?” Although there’s no simple answer, the journey to consultant begins at the start of your career. The Journey to Consultant Begins with Preparation ...
In Audit
Jan 1st, 2014
Independent physician practices can benefit from a clinical documentation improvement program. Clinical documentation improvement (CDI) is not a new concept, but it’s gaining momentum. The impetus for this trend is a double-edged sword: The government continues to intensify its efforts to detect healthcare fraud and abuse and recoup improper payments to providers and facilities; and ...
In Audit
Jan 1st, 2014
Know federal and state Medicaid policies for entitlement and their use. You shouldn’t expect your state Medicaid fund to pay or behave the same as other third-party payers, or even Medicare. Medicaid is a federal entitlement program incepted through Title XIX of the Social Security Act. The fund is maintained through a blend of state ...
In Billing
Jan 1st, 2014
Handle a breach with diligence: Investigate it, mitigate it, and implement corrective processes. Even a single patient’s HIPAA breach in 2013 needs to be submitted to the OCR by Feb. 28, 2014. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) has undergone many provisional changes over the years. Most recently, the U.S. Department ...
In Billing
Jan 1st, 2014
Don’t crack under pressure to get physicians paid immediately; stay compliant if incident-to is a must. There is a common compliance problem associated with integrating new physicians into existing group practices. In the usual scenario, when a new physician is hired, his or her information is provided to the billing staff, who must scramble to ...