A policy that UnitedHealthcare was poised to roll out that would have allowed it to retroactively deny ED claims isn’t moving forward yet. But that doesn’t mean case managers shouldn’t prepare for the payer, or others, to implement such policies.
The Office for Civil Rights (OCR) recently agreed to a settlement with a clinical laboratory over potential HIPAA Security Rule violations. Read about what led to the settlement and how your facility can avoid similar compliance risks.
CMS announced another round of changes to its Bundled Payments for Care Improvement program recently and said that while participation thus far has been voluntary, it may become mandatory starting as early as 2024.
Ensuring patients are being treated with the right level of care helps facilities allocate resources appropriately and keeps costs lower for patients and health systems.
Joe Rivet, Esq., CCS-P, CPC, CEMC, CPMA, CICA, CHRC, CHPC, CHEP, CHC, CICA, CAC, CACO, looks at the implications of a recent OIG brief on how Medicare Advantage organizations could use national provider identifiers (NPI) to monitor for fraud, waste, and abuse.
In July 2020, managed IT services provider Blackbaud disclosed it was the victim of an unnamed ransomware attack. The company paid the ransom, according to a January 14, 2021 report by the HHS Cybersecurity Program titled “Distributed Attacks and the Healthcare Industry.”
Audit results should be packaged to be meaningful and easy to follow. Apply these tips to create audit packages that providers will get the most out of.
Physicians can opt to base evaluation and management (E/M) level selection on medical decision-making. Learn how to interpret the new guidelines and ensure compliance.
