Posted and filed under Compliance, Cybersecurity.

What’s Up With These Updated Privacy Policies?

We’ve updated our privacy policy. Does this sentence look familiar? If you’re an active user of the Internet, then it should. Inboxes around the globe are being inundated with updated privacy policies, a verbose consequence of the European Union’s new set of privacy protections. The European Union’s General Data Protection Regulation (GDPR) went into effect…

Read the full article

Posted and filed under Compliance, Payers.

Meet Your New MBI

If you’re covered by Medicare, or if your patients are covered by it – you’re about to start feeling more of the effects of The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Most organizations have been preparing for MACRA’s ripple effects for years, so this wave of change may just be another to…

Read the full article

Posted and filed under Compliance, Cybersecurity.

Something Smells Phishy

Phishing is a common fraudulent practice that involves, “sending emails purporting to be from reputable companies in order to induce individuals to reveal personal information, such as passwords and credit card numbers”. Phishing is an example of deceptive social engineering, one that exploits cybersecurity weaknesses held across most industries, including healthcare. Phishing attempts are typically…

Read the full article

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

Your Data Will Be Stolen

This article is a continuation of Risky Retrievals. Walk-Ins Welcome Our medical record specialists are required to arrive at each facility with their equipment, as well as their ID badges and driver’s licenses. This is to ensure that their identities can be verified by office staff and reporting in the event of an incident. What…

Read the full article

Posted and filed under Compliance, Fraud, FWA, Healthcare, Medical Record Auditing.

Risky Retrievals

For years, whenever we began launching a medical record review project, clients and physicians alike would ask us the same question: Why can’t you come onsite to pick up the requested records? The easy answer would have been to say that we simply hadn’t performed record retrievals before, but we had vested interest in doing…

Read the full article

Posted and filed under Compliance, Healthcare, Payers.

The Road to Compliance

The road to compliance is long and bumpy, but a trip we must all take in 2018. In January 2017, compliance professionals from the Department of Health and Human Services (HHS), Office of Inspector General (OIG) held an assembly in which they discussed how to measure the efficacy of Compliance Programs. From this roundtable came…

Read the full article

Posted and filed under Compliance, Fraud, FWA.

Don’t Get Ghosted by Your DME Supplier

Medicare fraud maintains its position among the fastest growing crimes in the United States. The government loses nearly $75 billion a year to Medicare fraud; which has led to the conception of several anti-fraud initiatives, including the OIG’s Operation Whack-A-Mole (WAM). Medicare fraud comes in many shapes and forms, with the three most popular including:…

Read the full article

Posted and filed under Compliance, Healthcare.

Is OurNotes the Future of Documentation?

OurNotes is the name of an experimental, collaborative approach to clinical documentation that encourages providers and patients to co-produce medical notes. Researchers at the University of California, Los Angeles (UCLA) suggest that this kind of participation in the healthcare life cycle will improve overall engagement for patients, while freeing up time for their physicians. Taking…

Read the full article

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…

Read the full article

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…

Read the full article