Tag Archive | "compliance"

4 Motivators for Sticking to the Coding Straight and Narrow

Monday, May 8, 2017

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If you ever take the “throw everything out there and see what sticks” approach to coding, it’s time to rethink that strategy. Carefully choosing the wrong codes to bring in more money is no way to code either. Next time you need inspiration to steer clear of these methods, reach for these four reasons coding […]

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OIG to Office for Civil Rights – Enforce Your Own Standards

Friday, October 2, 2015

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The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) wants the HHS’s Office for Civil Rights (OCR) to do a better job of enforcing its own standards, according to a report the OIG issued in September. Report: OCR Fails to Protect Patients The OIG’s report says that when covered […]

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Learn Must-Know Appeals Changes Established By New Federal Law

Thursday, July 12, 2012

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Though New Federal claims appeals regulations went into implementation in 2011, if you haven’t gotten to know the law and honed your Employee Retirement Income Security Act (ERISA) knowledge, you could be costing your practice thousands. Read on for advice on how to master these rules. Background: The Patient Protection and Affordable Care Act (PPACA), […]

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Are You Leaving Money On The Table?

Wednesday, June 27, 2012

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National insurer data reveals that physicians undercode E/M claims to the tune of more than $1 billion every year. This is the money that physicians miss out on by reporting a lower-level E/M code and could have easily seized based on their documentation. Here are three reasons why should you always file claims based on […]

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Collect for Services When Your Practice Does Not Participate

Friday, June 15, 2012

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Many practices are choosing to not participate, or become “non-par,” with some or all payers, but such a thing can cause you to lose both money and time, especially if you don’t implement a solid, consistent plan of action. Let our experts help you start off on the right track to ensure you get every […]

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Your Present Financial Arrangements Can Land You In Sticky Situations

Wednesday, June 6, 2012

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Recently the government announced that its takedown made over 100 health care professionals to go out of business, thus reiterating the need to ensure that your compliance plan is secure. Check out these quick tips that can keep you out of hot water. Helping With Copays Could Hurt You With insurance restrictions on many Part […]

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Follow These Compliance Tips To Avoid Landing In Legal Hot Water

Friday, April 13, 2012

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Working in the healthcare sector can be tough, when it seems like not even a week can go by without hearing about a practice that has been accused of Medicare fraud. In fact, compliance issues can often be so subtle that you don’t even know they exist until an investigator points them out to you. […]

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Keep Yourself Safe From a Costly Lawsuit With These Tips

Friday, March 16, 2012

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If your compliance plan isn’t airtight, your coders, billers, and other support staff members could be a qui tam (whistleblower) lawsuit waiting to happen. Being the target of a whistleblower lawsuit could cost you dearly, and even close your doors forever. Follow this expert advice to head off an expensive and exhausting qui tam filing. 1.       Establish a compliance plan. If […]

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Follow OIG Compliance Plan Guidance Step-By-Step To Avoid Costly Lawsuit

Friday, March 9, 2012

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In this litigious environment, you need to tread lightly and have an effective compliance plan. Or else, you could be inviting a lot of trouble for yourself. Your plan should contain seven key elements, according to the HHS Office of Inspector General: Implementing written policies, procedures and standards of conduct; Designating a compliance officer and […]

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5010: Prevent NOC Drug Code Denial With This Advice

Thursday, March 1, 2012

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You might see more denials coming your way if you don’t pay attention to 5010 reporting of “not otherwise classified” codes. Here’s how to prevent your claims from getting one of those denials. The Problem: NOC Drug Codes Are Unsupported Giving inadequate information for non-specific HCPCS codes has become one of the most common reasons […]

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