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Medicare Compliance & Reimbursement

Enforcement:
Data Analysis Drives OIG's Biggest Takedown Ever
Feds continue to shine a spotlight on the opioid epidemic. Practices rely heavily on tech... Read more
Compliance:
Combat the 10 Most Common Claims Mistakes With This Expert Advice
Even your font choice could make a difference on your Part B claims. Clean claims are eas... Read more
Reimbursement:
Know These 5 Important Dates to Keep Medicare Pay on Target
Tip: Know the new CPT® 2018 codes that go live on Jan. 1. Medicare reimbursement is ofte... Read more
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Keep Phishers at Bay in 2018 with These 7 Tips
Hint: Proceed with caution if you aren't familiar with the contact. Malware attacks plagu... Read more
Industry Notes:
CMS Nixes Some Mandatory Bundled Payments for 2018
Plus: Expect a slight increase for your provider enrollment application fee next year. Th... Read more
Reimbursement:
Know These MACRA Updates to Ensure QPP Year 2 Pay
Get ready to report Cost measures in 2018 - that impact your 2020 paycheck. As CMS contin... Read more
Advancing Care Information:
Find Out What's New in 2018
Tip: Don't throw away that 2014 Edition EHR just yet. If you're planning on upgrading you... Read more
Compliance:
OIG Settlement Reveals Critical Need for EHR Vendor Vetting
Negligent software provider faces $155 million in paybacks to the feds. As most providers... Read more
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Focus On These 6 Timely HR Topics to Up Your Compliance Game in 2018
Tip: Check with your state's minimum wage standards to avoid reprisals. It's no surprise ... Read more
Industry Notes:
Two-Midnight Rule Court Case Adjusts Some Hospitals' Medicare Pay
Some providers will have a little more money in their pockets this holiday season, accordi... Read more
Industry Notes:
Double-Check Appeals' Requests and Jurisdiction, MAC Urges
CMS paperwork can be confusing, but one Medicare Administrative Contractor is reporting an... Read more
Industry Notes:
Feds Expand Opioid-Focused CPE Credits and Education for Pharmacists
The government wants pharmacists to be part of the frontline in the battle against the opi... Read more
Industry Notes:
Big Pharma VIP Tapped to Head HHS
Following the swift departure of Department of Health and Human Services (HHS) Secretary T... Read more
Industry Notes:
Hospices Need Increased Physician Involvement, OIG Warns
Hospices do important work, which is why they aren't exempt from scrutiny, the OIG's lates... Read more
Reimbursement:
New Programs, Delays, and Reductions Feature in the 2018 Fee Schedule
CMS finalizes telehealth, value modifier, and more - but delays plague the CY 2018 MPFS. ... Read more
Who Were the Winners and Losers in the 2018 Medicare Physician Fee Schedule?
A slight increase means most Medicare clinicians' pay will be steady in 2018. If you were... Read more
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Know These Medicare Remittance Rules for Deductibles and Coinsurance
Tip: Review secondary payers' policies to avoid paybacks. Copay collection remains one of... Read more
E/M Coding:
Master E/M Claims with Advice From Part B MACs
Could your payer be using the '4x4 method' to calculate your exam elements? Understanding... Read more
Industry Notes:
Senate Responds to AHA Study with EHR Legislation
In response to a massive American Hospital Association (AHA) study on the administrative f... Read more
Industry Notes:
Check Out New Medicare Appeals Options
If you rarely need appeals advice, that's a good thing. It means your claims are good-to-g... Read more
Compliance:
CMS: Verify Rotator Cuff Necessity or Expect MAC Takebacks
Tip: Sign your medical orders to avoid CMS scrutiny. A new report from Medicare should re... Read more
Take Note of These Documentation Tips
Implement these 7 claims review checks to avoid denials. There's nothing more frustrating... Read more
ICD-10 Coding:
Quiz: Test Your Code Knowledge On 5 Common Patient Issues
Tip: Know your diagnosis options for E/M codes 99497 and +99498. Whether you like it or n... Read more
Industry Notes:
Keep on Top of the Medicare Card Number Transition
As confusion continues to ebb and flow over new Medicare beneficiary numbers, CMS offers m... Read more
Industry Notes:
Know These CCI Edits for ED Coding
It's a common occurrence: The emergency room physician evaluates a patient by performing a... Read more
Industry Notes:
Protect Practice and Patients with Up-To-Date DUA
The transfer of protected health information and treatment data is critical to the practic... Read more
Industry Notes:
Voice Your Opinion — CMS Innovation Center RFI Closes Nov. 20
The CMS Innovation Center (CMMI) focuses on cutting-edge programs that support the engagem... Read more
Industry Notes:
Register Now for 2018 Virtual Groups Before the Dec. 1 Deadline
With the best intentions to assist smaller practices adjust to the demands of the Quality ... Read more
Compliance:
NGS Steps Back Its E/M Exam Policy Change Decision
Planned EPF and detailed exams updates are no longer considered mandatory. In a surprisin... Read more
Modifiers:
Master Modifier 57 to Boost E/M Pay With Procedures
Tip: Global days factor into whether to use modifier 25 or 57. Many practices are relucta... Read more
Home Health Reimbursement:
OASIS Edits Prompt Returned HH Claims Instead of Denials, MAC Says
Know the 3 necessary steps to resolve 37253 issues. The OASIS edit that took effect in Ap... Read more
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Consider This Claims Advice Before Your Next Appeal
Excessive appeals often alert payers to fraud. Denials are inevitable in the business of ... Read more
HIPAA:
Ensure Internal Protocols Are Ironclad to Stamp Out PHI Exposure
Payer's breach highlights the necessity of safeguarding sensitive information. Healthcare... Read more
Be Upfront About HIPAA Violations
Tip: If you meet the reporting exceptions guidelines, you may not have to report a breach.... Read more
Industry Notes:
Consider New DOS Guidance for Lab Tests From CMS
Plus: IMPACT Act elements shouldn't impact you in 2018. The date of service (DOS) for cli... Read more
Reader Question:
CMS Offers Claims Exceptions for Small Practices
Tip: Medicare will accept paper claims, but there are size restrictions. Question: O... Read more
Medical Review:
Don't Be a Moving Target — Clean Up Your Claims Now
All MACs will now perform Targeted Probe and Educate audits. With assurances to decrease ... Read more
Compliance:
Ignore ADRs and Pay the Consequences, CMS Warns
A prompt response is required under the Targeted Probe and Educate program. Before you sh... Read more
CPT® 2018:
Brace Yourself for 5 Major Coding Changes Effective Jan. 1
Hint: Read the section on observation codes carefully as the language has changed. On Oct... Read more
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Make These 7 Tips Part of Your Disaster IT Protocols
Hint: Store your back-ups at an offsite location for added protection. This hurricane sea... Read more
Non-Physician Practitioners:
Append Modifier SA on NPP Claims Now or Risk Denials, One Private Payer Says
Tip: Not all payers require modifier SA for non-physician practitioners performing an E/M.... Read more
Industry Notes:
Avoid the Aches and Pains of the Flu This Year
It’s no fun getting sick, but it can be even less fun for Medicare providers and the... Read more
Industry Notes:
OIG Continues to Hand Out Steep Penalties for Upcoding and False Claims
Upcoding is a focus area for the HHS Office of Inspector General (OIG), and often is the f... Read more
Industry Notes:
Acting HHS Secretary Named After Price Resigns
President Trump named Don Wright, MD, MPH as the interim secretary of the Department of He... Read more
Reimbursement:
Report 2017 MIPS Measures Now to Avoid a 4% Pay Cut Later
Oct. 2, 2017 is the deadline to start sending your QPP practice measures. If Medicare rei... Read more
Compliance:
Medicare Biller Gets Jail Time and Millions in Fines for Fraudulent Claims
Hint: You thought billers couldn’t be held responsible? Think again. Billers and co... Read more
HIPAA:
Hurricanes Make HIPAA Hard to Follow
Privacy controls are tough on a good day; find out what you can do in a disaster. As the ... Read more
Pocket This Advice for Times of Chaos
Tip: Make disaster planning a team effort. The critical importance of steady healthcare i... Read more
Industry Notes:
Review Period for QRUR Informally Open
The review period to check your 2016 annual Quality and Resource Use Reports (QRURs) opene... Read more
Industry Notes:
Mark Your Calendars for NPI Requirement Date
If you’ve lagged behind on using NPIs for checking patients’ Medicare status, ... Read more
Industry Notes:
This ICD-10 Mapping Tool Is Going Away Soon
The effective date for ICD-10 2018 code updates is fast approaching on Oct. 1, and for the... Read more
MACRA:
Spotlight on Virtual Groups: Are They All They're Cracked Up to Be?
Small practices may find relief by joining a virtual group under MACRA. Teamwork is often... Read more
Disaster Relief:
Hurricane Update: CMS and HHS Ease Requirements, Deadlines, and More
A Blanket 1135 Waiver allows for more flexibility in troubled times. As the flood waters ... Read more
Know These Coding Rules to Master Your Disaster Claims
You can append modifier CR for more than just natural disasters. In catastrophic situatio... Read more
Compliance:
Protect Your Practice with 5 Tips to Combat Fraud and Abuse
Precise notes can get you out of a compliance jam. In order to avoid the watchful eye of ... Read more
Industry Notes:
Hospice Compare Opens the Door for Public Scrutiny
If you’re concerned about improving your quality data, now might be the time to prio... Read more
Industry Notes:
Build Compliance Standards Into Your Plan for QMB Issues, CMS Says
New guidance from CMS reminds providers that just because you send bills to a Qualified Me... Read more
Industry Notes:
OIG Work Plan Suggests the MSSPs Save Money and Increase Pay
If you’re looking to increase your MACRA savvy and jump into an Advanced Alternative... Read more
Industry Notes:
HHA Case Underlines That "Straw Buying" Happens Even in Healthcare
Fraudulent home health providers continue to feel the focus of the OIG and Department of J... Read more
Industry Notes:
Kickbacks, Perjury, and Falsified Records Fetch 75 Years Jail Time in Landmark Sentence
A federal judge sentenced Marie Neba, co-owner of Fiango Home Healthcare Inc. in Houston, ... Read more
Compliance:
Shoddy Notes Factor Greatly in Incorrect Claims, CERT Report Says
‘Two Midnight’ rule contributes to a decrease in 2016’s improper payment... Read more
Revenue Booster:
Avoid These Top E/M Pitfalls Highlighted in the CERT Report
Hint: Keep the 3 key components in mind when you submit your claims. If your primary reve... Read more
Correct Coding Initiative:
Some Bundled Procedures Require More than Just NCCI Eligibility
Hint: Know which procedures require modifier 59, too. The National Correct Coding Initiat... Read more
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Master Global Days with this 5-Step Method
Use this primer to find out when you use MMM and ZZZ. As the length of postoperative peri... Read more
Industry Notes:
Meaningful Use Reporting Just Got Easier for Medicare Hospitals in 2018
Not all Medicare providers will report under Advancing Care Information in 2018. As of rig... Read more
Industry Notes:
DMEPOS Fee Adjustments Are in Full Swing
CMS issued a change request for Durable Medical Equipment, Prosthetics, Orthotics, and Sup... Read more
Industry Notes:
Do You Struggle with Patients' Requests for PHI? AHIMA Wants to Help
Patients with access to their protected health information (PHI) are more invested in thei... Read more
Industry Notes:
Check Out the EHC Program's Nifty New Offerings
The Agency for Healthcare Research and Quality (AHRQ) updated its Effective Health Care (E... Read more
Fraud & Abuse:
Recent Enforcement Highlights Feds' Wrath
False claims, kickbacks, drug offenses — this massive ‘takedown’ has it ... Read more
Compliance:
Avoid Fraud Problems By Understanding These 3 Fraud Laws
Hint: Though they both deal with referrals, Stark and AKS are not the same. As the OIG an... Read more
Reimbursement:
Expect Reduced Pay For Modifier 25 Claims, Insurer Says
One payer plans to cut modifier 25 claims in half, and others may follow. You probably us... Read more
Advance Beneficiary Notices:
Up Your ABN Game To Better Utilize Recent CMS Updates
Form changes went into effect on June 21 with advice for both providers and beneficiaries.... Read more
Industry Notes:
Prepare Now For These 3 CMS-588 Form Changes In Effect Next Year
Plus: Measure your Home Health stats against your peers with new PEPPER data. The Electro... Read more
Reimbursement:
CMS Remains Laser-Focused on Quality and Coordination, Proposals Suggest
Look for more changes ahead in telehealth, OPPS, and E/M. As MACRA’s reach extends ... Read more
Medicare Statistics:
How Will the MPFS Proposed Changes Impact Your CY 2018 Pay?
You might be surprised by next year’s intended shake-ups. As CMS continues to tinke... Read more
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Identity Theft Is On the Rise — Protect Your Practice Now
Identity mix-ups not only ruin lives, but put patients in harm’s way. Identity thef... Read more
ICD-10 Coding Quiz:
Master Summer Injury Claims with Advice From This 3 Question Quiz
Hint: The “W” code may help with claims processing. Summer fun often leads to... Read more
Industry Notes:
Don't Expect Any Quick Obamacare Replacements Anytime Soon
The Senate’s second attempt to repeal and replace comes up short. With expectations... Read more
Reimbursement:
Will You Be In or Out? Look at the Proposed MIPS Low-Volume Thresholds
CMS offers an olive branch to small and rural Part B providers. With Medicare reimburseme... Read more
Consider These Other QPP Modification Highlights in the New Proposal
Here’s a quick checklist of what’s changed in the 2018 proposed rule on MACRA.... Read more
E/M Coding:
Learn the Trick to Separating 99211 From Non-Billable Visits
Hint: In rare cases, 99211 can be used for a Rx pickup. Medicare providers likely report ... Read more
Revenue Booster:
Get Your Facts Straight on the Difference Between Incident-To and Split/Shared Visits
Tip: Your documentation defines the type of service provided. With physicians on vacation... Read more
Industry Notes:
Lack of Votes Delays Unpopular Senate Healthcare Bill ... Again
Medicaid suffers the brunt of the legislation’s cuts in the newest release. If the ... Read more
Industry Notes:
Concern Over NPI Fraud Prompts CMS Updates
New options and features allow for easier access amongst providers and suppliers. As priv... Read more
Industry Notes:
Don't Forget to Switch Out Your ABN Form
Tip: Watch the expiration dates. If you haven’t swapped out the old form for the ne... Read more
Industry Notes:
DOJ Case Illustrates the Woes of Upcoding
Shoot for necessity and accuracy when billing for the services you render. Upcoding sits ... Read more
Reader Question:
Can You Bill Medicare Even If You Aren't Enrolled?
Understand the out-of-network payment option. Question: Our orthopedic practice sees... Read more
Compliance:
OIG Cracks Down On Rising Improper Payments
The federal watchdogs recovered billions and even obliterated a motorcycle gang’s &l... Read more
ICD-10 Coding:
Take a Peek at ICD-10-CM Changes and Updates for 2018
Utilize these current diagnoses code revisions to track trends for the next reporting year... Read more
Patient Engagement:
Enhance Your Patient-Provider Relationship By Adopting New Texting Technologies
Tip: If you want to connect with your patients, think outside the box. Health IT is const... Read more
Text Your Patients, But Keep HIPAA in Mind
Staff training is essential to avoid messaging mishaps. As the healthcare tide continues ... Read more
Industry Notes:
Keep Your Compliance Calendar on Task or Face the Consequences
Plus: Get ready for the Medicare card makeover in 2018. Don’t shelve that complianc... Read more
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Keep This Social Engineering Glossary Handy for Quick Reviews
Tip: Don’t get spoofed. Are you IT savvy? Could you spot a man-in-the-middle infilt... Read more
Compliance:
Fraud and Abuse: OIG Targets Opioid Abuse, Home Health, and Children's Health
Tip: Watch your early discharge rates. The OIG makes scores of recommendations every year... Read more
See What's On the OIG's To-Do List
The OIG zeroes in on HHS struggles with health IT, prescription drugs, and more. Many of ... Read more
Benchmarking:
How Does Your Physical Therapy Billing Stack Up Against Your Peers?
Medical necessity trips up PT claims. If you wonder where you stand in relation to other ... Read more
Practice Management:
Combat Social Engineering Hacks with These Expert Tips
If the email looks phishy, go with your gut. It only takes one click to bring down your o... Read more
HIPAA Quiz:
Test Your HIPAA Expertise with This Compliance Quiz
Hint: Check vendor references before you send over your practice data. You are likely an ... Read more
Industry Notes:
Worried About the QPP Transition? CMS Offers an Olive Branch
Plus: There’s a breakdown on the bundle brigade … again. With the online too... Read more
Cybersecurity:
Secure Your Systems Against Ransomware or Pay the Price
Look at this insight into the WannaCry ransomware attack impacting healthcare worldwide. ... Read more
Are You the Victim of a Cyber Hack?
Survey this checklist if you think your system’s in the grip of a virus. Do you eve... Read more
Be Cyber Aware:
Draft an Airtight EHR-Back-Up Plan
Hint: Patient safety should be your first priority in a malware attack. It’s no sec... Read more
Compliance:
The RACs Slide Into Summer with a Hefty Junket of Audit Issues
The pressure is on, so prepare accordingly for possible reviews. No practice wants to hea... Read more
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Reimbursement: Master Global Periods with This Top 10 Check List
Hint: Not all services are bundled into a global surgical period. In most cases, you can ... Read more
Industry Notes:
Check Your MIPS Status with a New Tool from CMS
If you’re worried that your Merit-Based Incentive Payment System (MIPS) lett... Read more
Industry Notes:
Cahaba Advises on Rise in Appeals Form Issue
If your Medicare appeal gets the reject stamp, it’s likely due to a missing or incor... Read more
Industry Notes:
Dermatologist's Fraud Conviction Could Bring a Sentence of Up to 120 Years in Prison
Medical necessity continues to be the defining factor in most fraud cases, a Chicago derma... Read more
Industry Notes:
Interested in MSSPs for 2018? Don't Forget to Submit Your Application by May 31
Medicare Shared Savings Programs (MSSPs) and Medicare Accountable Care Organization (ACO) ... Read more
Reader Question:
Don't Let No-Shows Hurt Your Bottom Line
Question: Our practice income is being negatively impacted by no-shows, and telephone... Read more
Compliance:
Policy Update: NGS Announces New Guidance on Exam Levels
Detailed exams to require 6-7 body areas or organ systems starting July 1. If you find ev... Read more
MACRA:
Reimbursement Update: Keep a Lookout for Your MIPS Invite, CMS Says
Even if you don’t meet the threshold, you should still prepare for future MIPS adopt... Read more
Are You Ready to Report? Here's a MIPS Refresh If You're Not
MIPS is the entryway for most physicians into the new Quality Payment Program under MACRA,... Read more
HIPAA:
Institute Home Office Protocols to Protect PHI and Yourself
Avoid stiff penalties that could hurt your practice. When you take files out of the offic... Read more
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Keep this HIPAA Breach Primer Handy to Avoid Notification No-Nos
Hint: Failure to notify your patients of a PHI breach early on can get you in hot water. ... Read more
Revenue Booster:
Test Your Coding and Billing Knowledge to See Where You're Losing Money
Hint: Detailed notes help you prove medical necessity to appeal denials. With the high co... Read more
Industry News:
New AMA Primer Advises Providers on Opioid Issues
Talk to your patients about opioid abuse before they leave the office. With the opioid ep... Read more
Compliance:
Revisit AWV Fundamentals to Avoid a RAC Review
 Distinguish between “one-time-only” and “subsequent” for ann... Read more
Prepare Ahead of Time for a RAC Audit with These Practice Basics
Tip: Make sure your documentation is in order and easy to read for auditors. The most suc... Read more
Reimbursement:
Boost Your Capital with This Expert Coding Advice
Follow coding mandates to avoid audits. When you don’t check over the documentation... Read more
Home Health:
CMS Offers HHAs Relief with a 6-Month Reprieve on HH CoPs
Hint: Keep your staff in the loop and educate appropriately during the transition. Someti... Read more
HIPAA:
A Clear Understanding of HIPAA Security Will Help Save Money
Tip: Outline your plan in writing now to protect yourself later. According to the HHS-OCR... Read more
Industry Notes:
Review Your Open Payments Data Before It's Too Late
Plus: Look at the new reporting option for kickback self-disclosure. It’s that time... Read more
MACRA:
Still in the Dark About MACRA? Master the Basics with This Information
Despite a massive media blitz, many providers are confused about what to report. Quality ... Read more
Reimbursement:
Got MIPS? Use This New CMS Tool To Ease Your Larger Practices Into MACRA
If you’re game, consider the CAHPS Survey for MIPS as an add-on. If you’re st... Read more
Compliance:
Check Audit Worries at the Door With These 7 Steps
Be ahead of the charge with a fail-safe, audit-response plan. No matter how careful you a... Read more
Reimbursement:
Don't Let Front Desk Confrontations Impact Copay Collection
Experts: Give patients a few chances to pay, then call collections. Copays are standard f... Read more
HIPAA:
Is Your Practice Safe from an Internal Cyber Attack?
Network monitoring helps prevent “inside jobs.” Cyber hacking is on the rise,... Read more
Industry Note:
ACA Repeal Dead — No, Not Yet, Say House Conservatives
After the votes were coming up short for a repeal of the Affordable Care Act — nickn... Read more
Industry Note:
Prolonged Services Options Have Their Limitations
Remember those E/M codes for prolonged services that CMS offered up back in the fall and a... Read more
Industry Note:
CMS Sidelines New EPMs for More Review
If you were looking forward to taking advantage of new bundled payment offerings in the co... Read more
Policy:
House Offers an ACA Replacement with Mixed Results
Healthcare orgs say new plan hurts the most vulnerable. Campaign promises were met on Mar... Read more
HIPAA:
Understand What Constitutes A Business Associate
Hint: Your practice cleaning service probably doesn’t need a BAA. When there’... Read more
Compliance:
Steer Clear of The Fire with New Insight on the 60-Day Rule For Overpayments
Don’t forget about the six-year lookback period, too. Accidents happen. And, when y... Read more
Telehealth:
Master Telemedicine with New Options from CMS
As telehealth services continue to evolve, look for guidance to come from your MAC. Virtu... Read more
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Boost Your Practice Revenue with a Media Blitz
Tip: Make sure you keep it legal before you put yourself out there. Competition is fierce... Read more
Industry Note:
Running Behind on Your 2016 PQRS Submissions? CMS Just Extended the Deadline
With Medicare changes coming left and right, CMS offers some relief to providers trying to... Read more
Industry Note:
Physician's Claims Were a Dead Giveaway That He Was Up to No Good
Alleging a higher-level service than you actually perform results in a false claim —... Read more
Industry Note:
CCM Gets Some Medicare Love with a New Awareness Campaign
Over the last year, the output of programs and initiatives from CMS and the CMS Innovation... Read more
Compliance:
Feds Continue to Take No Prisoners When It Comes to Medicare Fraud
Despite funding cuts HHS and company remain vigilant in their fight to recover assets. ... Read more
Reimbursement:
Think You Should Use a Level 3 E/M Code for Hospital H & P? Think Again
Compare your claims against other Medicare providers to see if you fall within the norm.... Read more
Know the Concurrent Care Rules for Billing Subsequent Hospital Services
MACs focus on diagnosis and specialty to differentiate concurrent care. If you perform... Read more
Home Health:
First-Rate Documentation Helps in the Defense of Observation & Assessment Visits
Look to your MAC for guidance on medical necessity. Don’t let slipshod observati... Read more
Industry Note:
Verma Passes First Hurdle Toward CMS Admin Confirmation
Confirmation hearings continue on Capitol Hill for President Trump’s nominees in v... Read more
Industry Note:
CMS Considers New APM to Promote Innovation in Pediatrics
Even though the fate of the ACA is in limbo as legislators weigh other options to replac... Read more
Industry Note:
Worried About Cybersecurity and Its Effect on Healthcare? NIST Wants to Know
Whether you are feeling stellar about your practice health IT or you’ve just repor... Read more
Compliance:
Put Device Encryption at the Top of Your Compliance To-Do List
Keep your devices locked and your laptops under watch, OCR case suggests. Accidents ha... Read more
Reimbursement:
Boost Your Bottom Line with Advice from This A/R Checklist
Keep track of your Accounts Receivable to preserve your financial livelihood. Now, tha... Read more
Refresher Course:
Master A/R with This Handy Tool
Calculate your days in Accounts Receivable with this how-to guide. When your practice ... Read more
HIPAA:
Be Safe and Allocate Funds for Implementing HIPAA
When you outline your office budget, put cash aside for compliance planning. It’... Read more
Update Your Office HIPAA Protocols to Avoid the Maximum Penalty
Look at this handy guide to put a new spin on your compliance plan.  HIPAA compli... Read more
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Get to Know the Clinical Practice Improvement Activities Category in MIPS
Keep this helpful outline nearby when you start to report your CPIA measures. The Meri... Read more
Industry Notes:
Last Call: Report 2016 MU Measures Before The Program Ends
Plus: Reassigning benefits? You need a new form for that.  CMS has extended its d... Read more
Compliance:
Steer Clear of Upcoding to Duck the OIG's Reproach
Concise notes decrease the chance of billing errors. Perennially, the OIG ranks upcodi... Read more
A Pre-claim Review Prevents Coding Catastrophes From the Get-Go
Take a look at these tools to update your coding compliance plan. Never underestimate ... Read more
Unbundling? Expect To Be Unpaid
Keep upcoding on your radar, but watch for double-billing errors, too. If you’re... Read more
Reimbursement:
Combat MACRA Fatigue with These Helpful Tips
Are you exempt from the Quality Payment Program? To many, it feels like CMS is unloadi... Read more
ICD-10 Coding:
Manage Mistakes with ICD-10 Coding Advice You Can't Afford to Ignore
The seventh character is key to overcoming your coding fails. The ICD-10 honeymoon is ... Read more
Health IT:
Look to the Cloud If You Want to Raise Your Revenue
Cloud-based EHRs make it easier for small practices to keep up.  Health IT can be... Read more
Industry Notes:
Price Passes First Hurdle, But Still Has a Ways to Go to Win the Race
Plus: Uncertainty over ACA repeal causes industry frustration and consumer consternation... Read more
Reimbursement:
Practices Found Themselves Out $342 Million with Downcoded E/M Visits to Blame
Insufficient documentation leads the error list, the 2016 CERT results reveal. Though ... Read more
Compliance:
Don't Get Burned–Report Your Breaches Now Or Risk a Higher Penalty Later
The HHS says there is no excuse for dragging your feet on reporting a HIPAA violation. ... Read more
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Never Underestimate the Importance of Detailed Documentation in Coding
Auditing your staff documentation techniques will keep your payments on the up-and-up. ... Read more
Are Your Business Associates to Blame for Your HIPAA Problems?
Safeguard your practice and your livelihood with a strong business associate agreement. ... Read more
Health IT:
Ensure Your EHR Leads to Healthcare Salvation with the Right Implementation
A difficult transition to a new EHR causes financial strain for a Texas cancer center. ... Read more
Exclusions:
Providers Who Interfere with OIG Investigations May Find Themselves Excluded
HHS final rule suggests hindering the audit process may lead to exclusions. Exclusion ... Read more
Industry Note:
Major Changes Are Ahead As the HHS Transitions Under a New Administration
With President Obama now gone and President Trump taking up residency in the White House... Read more
Industry Note:
NJ Clinical Lab Associate Gets 20 Months in Prison in Bribery Case
Unfortunately, corruption abounds in the healthcare industry despite the best intentions... Read more
Industry Note:
ICD-10 Glitch Causes CMS to Slacken PQRS Requirements
The transition from ICD-9 to ICD-10 has had its fair share of ups and downs. But, a rece... Read more
Compliance:
CMS Offers Some Insight on What MACRA May Mean for Coding
New updates give coders a glimpse at possible additions as MACRA shapes Medicare. Wit... Read more
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Advancing Care Information Offers Reduced EHR Reporting Under MACRA
MACRA’s new EHR component offers easier options for confused clinicians. As Adva... Read more
Reimbursement:
Not Sure If You Fall Under MACRA's Quality Payment Plan? Find Out
Take a look at these requirements to see if you are expected to transition. As CMS sh... Read more
Modifiers:
Get the Facts on Modifier 24 and Reap the Benefits
Take full advantage of modifier 24 with these tips on the best way to code it. Evalua... Read more
Industry Note:
OIG Continues to Turn Up the Notch on Prescription Drug Offenders
As the opioid-abuse epidemic threatens to undermine Medicare, the OIG maintains its vigi... Read more
Industry Note:
CMS Offers 2 New Quality Measures On 'Transfer of Health Information and Care Preferences'
You can get a sneak peek at two more IMPACT Act-required quality measures if you partici... Read more
Industry Note:
New Savings for You As the IRS Mileage Reimbursement Rate Drops for CY 2017
If you base your travel reimbursement to employees on the IRS’s standard mileage r... Read more
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