Build a good defense against a HIPAA audit or breach. The HIPAA Security Rule makes a risk analysis mandatory for all HIPAA covered entities (CEs) and business associates (BAs). This section of the rule is found in the Administrative Safeguards and states: “Conduct an accurate and thorough assessment of the potential risks and vulnerabilities to ...
Maximize revenue cycle profits by watching bundling. Becoming knowledgeable about National Correct Coding Initiative (NCCI) policies and edits may be the difference between having a profitable revenue cycle or placing your facility at risk for denials. In recent years, NCCI policies and edits have become key factors in outpatient facility and professional claims denials. You ...
In CMS
Feb 28th, 2017
New compliance program guidance has been issued by the Fraud Section of the Department of Justice (DOJ), according to an article published in the AHLA Weekly. Although the “Evaluation of Corporate Compliance Programs” (Guidance) is not specific to the healthcare industry, it does provide a practical set of benchmarks against which the audit & compliance committee, in ...
Time to give your facility’s compliance plan an annual preventive exam. The Office of Inspector General’s (OIG’s) annual work plan reveals its plans for new, revised, and ongoing reviews and audits of U.S. Department of Health and Human Services (HHS) programs and operations. This year, OIG has set its sights on 24 significant new issues, ...
Nov 15th, 2016
To provide proper patient care and to carry out daily business functions, healthcare organizations must obtain patients’ sensitive medical details and demographic and account information. In return, patients should be able to trust that the information they provide, known as protected health information (PHI), will be maintained securely and confidentially. Since HIPAA was enacted in ...