Compliance

  • The demand for physicians available for hospital call coverage is rising, but such arrangements must be structured carefully to avoid running afoul of the Stark Law and AKS. Since every arrangement is different and unique to the circumstances of specialty, geography, demand, and other various concerns,   Read more..
    Posted on 11 Sep, 2017
    Compliant On-Call Coverage Arrangements
  • Documentation helps to inform and support providers by supplying information to highlight trends, providing insight into disease processes, and uniting physician teams and payers through the flow of data. Clinical records provide uniformity and continuity across visits, hospitals, physicians, and payer providers. Bottom Line: Documentation is the   Read more..
    Posted on 8 Sep, 2017
    Clinical Documentation: Why is it so Important?
  • KNOW THE BASICS
    You append modifier 22 (Increased procedural services) to a CPT® code to indicate that a surgical procedure requires physician work substantially greater than that usually required to perform the service. There is unfortunately no one standard definition of what “substantially greater” effort means. You should   Read more..
    Posted on 15 Aug, 2017
    Don’t Labor Over Modifier 22 – Increased Procedural Services
  • “During my year in business school, I learned two different methods for improving modes of production, Kaizen and Lean Six Sigma,” says Sam Goldberger, MD, MBA in his book A Method That Works: How to Take Your Ophthalmology Practice to the Next Level and Have   Read more..
    Posted on 27 Jul, 2017
    Kaizen & Lean Six Sigma for Your Medical Practice: Because Everything Can Be Improved and Should Be
  • MACRA stress is high, and MACRA readiness is low, according to a recent AMA/ KPMG survey that reports less than one of four physicians define themselves as "well prepared" to meet the Medicare Access and CHIP Reauthorization Act of 2015’s requirements for this year. 1,000 physicians   Read more..
    Posted on 19 Jul, 2017
    MACRA Preparedness: And the Survey Says…
  • As MIPS and other value-based reimbursement plans gain steam, your patients’ perceptions of the quality of their medical care will affect your bottom line. It’s not enough to tiptoe around the required quality measures under MIPS—you’ll need to embrace new strategies to up the ante   Read more..
    Posted on 5 Jun, 2017
    What Do Your Patients Think?
  • In a nutshell, the Quality Payment Program rolled out January 2017 creates an environment where you—the eligible clinician—compete for incentive dollars.
    In this new program, you may earn incentive payments by participating in Advanced Alternative Payment Models (APMs), which involve meeting specified criteria and accepting some risk for your patients’ quality and cost outcomes.   Each Innovation Models falls into one of seven categories: Accountable Care Accountable Care   Read more..
    Posted on 31 May, 2017
    Pin Down the Innovation Models in the Quality Payment Program
  • National Health Service hospitals in the UK forced to cancel outpatient appointments after WannaCry ransoms files
    It makes you wanna cry—the ransomware attack that raged to endemic proportions from one unpatched Windows computer to another faster than any biological agent possibly could (infecting more than 300,000 Windows computers in more than 150 countries at last count). We won’t soon forget the Wanna   Read more..
    Posted on 22 May, 2017
    Cyberattack Targets Healthcare and Succeeds
  • Self-auditing should occur at least annually, experts say.
    If you want your coding to be bulletproof, your practice should invest in regular self-audits. Why? If you conduct self-audits regularly, you reduce the risk of a payer audit. Self-audit carefully, and you can fix coding problems before they get bigger. “It is easier to fix a   Read more..
    Posted on 16 Feb, 2016
    Make Coders First Line of Self-Audit Defense
  • Be as accommodating as you can with patients who want to access their info.
    Patients requesting access to their medical records should be a top priority for any practice that wants to stay compliant and trustworthy. The basics: A patient has every legal right to her medical records, and if you don’t provide access ASAP, not only could you run   Read more..
    Posted on 5 Feb, 2016
    Responding to Patient Records Requests? Follow This Expert Advice

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