Posted and filed under Coding, Compliance, Healthcare.

Listen Up, Doc. These MACRAnyms Can Make You Money in 2017.

If you’re in the healthcare industry – you’ve heard about MACRA. The Medicare Access and CHIP Authorization Act, Medicare’s two-track payment system for physicians and healthcare providers will be implemented on January 1st, 2017. Understanding the new system and rules that comes along with MACRA’s implementation is vital for the success of physicians and hospitals….

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Posted and filed under Coding, Compliance.

Understanding the Vaccines for Children Program

Please refer to our accompanying article Vaccine Administration Counseling for more information on vaccine coding and documentation. The Vaccines for Children (VFC) Program is a federally funded program that offers vaccines at no cost for eligible children through doctors enrolled in the program. The CDC provides information for Healthcare providers to become a VFC provider….

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Posted and filed under Compliance, Cybersecurity.

How Incident Response Plans Can Save Your Bottom Line

In June Advize Health’s very own Joshua McElroy participated in a panel hosted at WellCare in Tampa, FL. Joshua was in the company of three other subject matter experts from Schellman & Company, Bright House Networks, and Kroll who all spoke on the topic of “Incident Response Plan: From a Reactive to Proactive Approach”. The…

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Posted and filed under Compliance, Fraud, Healthcare.

Healthcare’s Data Vulnerability Problem

A study conducted by three universities has revealed a fatal flaw in the healthcare industry’s cyber security operations – lack of cohesion between cyber security protocol and the proper execution of such procedures. Healthcare organizations are vulnerable to data breaches because cyber security efforts are perceived as an interruption of clinical workflow, rather than as…

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Posted and filed under Compliance, Healthcare.

Cybersecurity: Are You Helping the Hackers?

Last year, Houston-based software and security company Netiq released a Cyberthreat Defense Report that published alarming statistics on the apparent vulnerabilities in Healthcare IT. Data breaches, compromised patient information, medical identity theft, and gaping holes in Cloud infrastructure are among the top contenders for worst offenses. Now, a year later, the statistics are rising, and…

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Posted and filed under Compliance, FWA.

Clinical Labs Under Heavy Scrutiny After Cigna Lawsuit

A tidal wave of fraud has been approaching our shores for quite some time, and it’s finally broken land. The scheme, gaining popularity in clinical labs and pathology groups involves waiving patient fees and copays in order to send payer groups inflated claims fees. While these billing tactics might seem innocuous, they are fraudulent because…

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Posted and filed under Business, Compliance.

The Consequences of HIPAA Violations

 The below tiered civil penalty structure was established from the American Recovery and Reinvestment Act of 2009. The Secretary of HHS still has discretion in determining the penalty amount based on the nature and extent of the violation as well as the nature and extent of harm resulting from the violation.  The Secretary is prohibited…

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Posted and filed under Compliance, Healthcare.

2016 Update: OIG/OCR Audit Process

OCR’s Privacy, Security, and Breach Notification Audit Program: Although the ever-expanding use of health information technology in health care provides many benefits, in turn it poses new risks to consumer privacy. To ensure HIPAA compliance, HITECH requires HHS to perform periodic audits of covered entities and business associates. In 2011 and 2012, OCR conducted a…

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Posted and filed under Compliance, Healthcare.

The Hopeful Future of Sharing Behavioral Health Data

The Colorado Regional Health Information Organization (CORHIO) is launching a pilot program to improve patient information exchange between providers and caregivers. This program is designed in a way that once consent is given by patients, their Behavioral Healthcare Information will be shared with long term care providers and hospitals. The newly accessible documents will summarize…

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Posted and filed under Coding, Compliance, Medical Record Auditing.

Advize Health Meaningful Use and Security Risk Analysis Webinar Recap

On March 10, Advize Health held our fifth monthly webinar on Meaningful Use and Security Risk Analysis. For this webinar, Advize Health’s auditor Melissa Jewett presented with Don Waechter from Compliance and Remediation Services, LLC. Both Melissa and Don are highly qualified to deliver such an informative webinar; as Melissa is a Certified Professional Coder…

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