CMS has instructed MACs to reprocess claims and providers to reimburse beneficiaries due to a miscalculated copayment for stereotactic radiosurgery, according to the October update to the OPPS and Integrated Outpatient Code Editor (I/OCE).
Conducting pre-billing audits can be challenging, but when done correctly, it can save organizations from spending time recoding and rebilling claims that payers deny. These audits can be conducted on the front end, in both inpatient and outpatient settings, once records have been coded.
The majority of Recovery Auditor (RA) takebacks in the past year involved hospitals (88%) and physicians (5%), which isn’t surprising because of the volume of services they provide, says De
We are four months into the new fiscal year and the Office of Inspector General (OIG) has finally released its highly anticipated Work Plan. Click the link above for more information and an in-depth analysis.
When Shallie J. Bryant, CHC, CHPC, went to work at CaroMont Health in North Carolina more than two years ago, her biggest challenge was creating a culture of patient privacy.
The reason R. Brett Short, chief compliance officer at UK HealthCare at the University of Kentucky, talks about his organization’s OCR audit is to share the lessons he learned.
UK HealthCare’s Albert B. Chandler Hospital was one of 20 covered entities to undergo an initial test audit by the OCR in 2012.
Every healthcare organization should develop and implement a policy and a well-defined process that provides guidance for managing incident and breach response.
To comply with the HIPAA omnibus final rule, healthcare organizations need to revise their risk assessment process to determine whether they must notify affected individuals of a breach.
This year's Recovery Auditor Benchmarking Report surveyed 325 respondents, representing both small and large hospitals, from all four Recovery Auditor regions. It may not come as a huge surprise to many that the main theme of this year's survey is the expanding state of the Recovery Auditors (RA), and the fact that they continue to gain speed and extend their reach.
