As part of our continuing series, BOH caught up with Rebecca Herold, CDPSE, FIP, CISSP, CIPM, CIPP/US, CIPT, CISM, CISA, FLMI, to ask the privacy expert HIPAA compliance questions.
Certain provider services such as acupuncture and cosmetic surgery are not reimbursed by Medicare. This article describes when and how to apply HCPCS modifiers for non-covered services.
Facilities can limit their exposure to claim denials and external reviews by implementing a robust internal coding compliance program. This article breaks down components of a coding policy and compliance plan and approaches to monitoring coding quality.
Although many provisions of the 2022 Outpatient Prospective Payment System (OPPS) final rule are a light lift for hospitals, several have far-reaching implications. Apply these expert tips to ensure you're up to speed and aware of compliance pitfalls.
Having a good lawyer often comes in handy. Having a lawyer who understands HIPAA and works well with your HIPAA compliance officers, though, is priceless.
Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO, writes about key regulatory updates in the 2022 Outpatient Prospective Payment System (OPPS) final rule, including increased price transparency penalties, changes to the inpatient-only list, and payment changes.
Query forms need to be vetted and approved and must follow appropriate guidelines to be compliant. Brush up on current query guidance to ensure you and your organization are following best practice.
Interventions to reduce length of stay for high-risk, medically complex, and otherwise vulnerable patients are falling short, according to a technical brief prepared for the Agency for Healthcare Research and Quality.
A case manager learns that a soon-to-be discharged patient’s electricity has been turned off for nonpayment and makes arrangements to have the bill paid and power restored. While this is clearly important to the patient’s health, it is also an example of how case managers may be unintentionally violating the law.
Calling all revenue cycle and revenue integrity experts: NAHRI is currently seeking speakers for the 2022 Revenue Integrity Symposium (RIS), to be held September 19–20 in Phoenix, Arizona.
