Posted and filed under Compliance, Healthcare, Payers.

HHS Retracts Support For Financial Assistance Charity

In an unexpected, albeit responsible move, Health and Human Services has retracted their support for a Patient Assistance Program. The Caring Voice Coalition (CVC) is a patient assistance charity that provides financial support to Medicare beneficiaries and other patients. Found in 2003 with seemingly noble intentions, the CVC was founded in 2003 to support patients…

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Posted and filed under Compliance, Fraud, FWA, Healthcare.

Examining The Fraud Triangle

Federal healthcare fraud recoveries totaled upwards of $2B in the first half 2017’s fiscal year. This staggering sum is proof enough that healthcare fraud is here to stay as an unfortunate reality of the industry. Providers, patients, and insurers alike have all been complicit in various scams and schemes – which brings to mind the…

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Posted and filed under Compliance, Fraud, FWA.

Advize Returns From NHCAA 2017

Last year we had the ONE AND ONLY cheapest.booth.ever featured at NHCAA’s Annual Training Conference. This year Advize brought guacamole and cookies to the table at the Even Cheaper Cheapest Booth Ever. Advize Health had the honor of speaking with some of NHCAA’s Annual Training Conference (ATC) attendees right in our backyard. The ATC is widely-regarded…

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Posted and filed under Compliance, Cybersecurity, Technology.

HITRUST Community Extension Program

We would like to thank HITRUST, our friends Schellman & Company, LLC, as well as today’s host, Orlando Health, for inviting us to join them in the HITRUST Community Extension Program Orlando. We’ve discussed HITRUST in previous blog posts and presentations, but we find that it’s important to revisit this topic as the year comes…

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Posted and filed under Coding, Compliance.

Clinical Documentation vs. Patient Care

The keystone of Clinical Documentation Improvement is that quality documentation often results in quality continuum of care, and while this is true, many physicians report that paying too much attention to documentation actually leads to poor patient care. This poses a dilemma for some providers; do they care for the chart or for the patient…

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Posted and filed under Compliance, Technology.

EHR Incentive Program Deadlines

The Medicare and Medicaid EHR Incentive Programs were designed to provide eligible professionals (EPs) the opportunity to receive EHR incentive payments as they adopt, implement, upgrade, or practice meaningful use of relevant EHR technologies. The EHR Incentive Programs have three stages: Stage 1 set the foundation for the EHR Incentive Programs by establishing requirements for…

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Posted and filed under Compliance, Cybersecurity.

How Health Care Law Can Fix the EHR Problem

In what has been touted by industry experts as, “…the most important article no one [else] will read”, The Sedona Conference Journal has released an article diagnosing the many legal “illnesses” that plague Electronical Health Records (EHR), and the subsequent sharing of private information.  EHR was once regarded as the savior of health care information…

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Posted and filed under Compliance, Medical Record Auditing.

Sign, Seal, Deliver: Provider Signature Requirements

To a physician, providing authentication may appear as yet another inconvenience or hindrance to productivity in the midst of the already chaotic audit process – but it’s the difference between being reimbursed and having your claims denied. For the purpose of a medical record audit, Medicare requires that any services provided be authenticated within the…

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Posted and filed under Compliance, Medical Record Auditing.

Surviving the Medical Record Retrieval Process

Tackling a project as intricate as Medical Record Retrievals may seem daunting – and it is, but you can still make it through unscathed. Perhaps your firm was enlisted by an attorney, health plan, or medical auditing organization to retrieve medical records directly from a provider’s office. What tools do you need? How do you…

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Posted and filed under Coding, Compliance, FWA, Healthcare.

Pre-Litigation Considerations

Law firms have been known to enlist the help of a third-party when dealing with healthcare fraud cases. This is because in addition to investigating the allegations against one party, there is a myriad of additional pre-litigation considerations. In multi-faceted cases in which health plan overpayments are being pursued within the judicial system an audit…

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