Compliance

  • 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
  • Pay attention to this coding hotspot quintet to minimize audit chances.
    Most medical practices live in fear of the audit. Even with the most robust policies in place, there’s always that feeling that the practice could be doing more in case a payer wants to check your books. Luckily, you can count on advice from experts like   Read more..
    Posted on 19 Jan, 2016
    Keep Practice out of Auditor Targets by Knowing These Triggers
  • Just FYI: IRS can help you out of hot water.
    If your practice is worried about the possibility of having its Medicare and other insurance identities stolen, you can rest easier if you save these tips from Medicare experts. Impact: According to Shantanu Agrawal, MD, a medical director with CMS, more than 3,600 physician and patient cases   Read more..
    Posted on 6 Jan, 2016
    Stay Ahead Of ID Thieves with Proper Protection
  • Patient won’t sign ABN? Be sure to document it.
    In certain situations, it might prove difficult to get a signed advance beneficiary notice (ABNs) from a patient when appropriate. Make every effort to get the ABN for any service that Medicare might not pay for, however, or your office could be financially responsible for   Read more..
    Posted on 28 Dec, 2015
    Get Signed ABN When Possible To Cover Potential Non-Payment
  • ABNs can also help build rapport with patients.
    If your practice doesn’t obtain signed advance beneficiary notices (ABNs) when necessary, it could be letting deserved reimbursement fly out the window. Reason: Whenever your practice provides a service that Medicare might not cover, or cover completely, the ABN notifies the patient of that fact. Having   Read more..
    Posted on 19 Dec, 2015
    Think Medicare Might Not Pay? Get an ABN
  • Medicare will only accept stamped signatures in cases of disability.
    When your physician or another provider performs a medical service for a Medicare patient, he must include either a handwritten or electronic signature in order to authenticate that fact. Consequences: If you submit claims without a signature that passes muster with Medicare, you could be in   Read more..
    Posted on 2 Dec, 2015
    Validate Signature Before Signing Off On Claims

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