Posted and filed under Community, Payers.

Is HHS About to Lose Funding?

Yesterday, President Donald Trump presented his $4.4 trillion FY19 budget proposal – and it looks like the Department of Health and Human Services (HHS) is going to have to tighten its fiscal belt. Trump’s proposed budget demonstrates a 21% decrease from HHS’ 2017 budget. That means the agency may be facing a cut as steep…

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Posted and filed under Events, Healthcare.

Health IT Day 2016

AFCEA Bethesda Chapter’s Health IT Day is an annual gathering that operates as a nexus of information exchange for Health Information Technology and Cyber Security Professionals. CXO level executives from federal and civilian initiatives gather to discuss healthcare for civilians and military consumers – and how to improve the healthcare experience through interoperability. With Keynotes…

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

The Great Divide: Federal vs. Commercial Health Plan Reviews

Commercial Health Plans The act of tailoring medical record audit procedures to the needs of a particular health plan is not a novel concept. Different commercial healthcare payers maintain requirements unique to their served populations, and audits are consistently slightly augmented in order to focus on E/M, specific and proper modifier usage, and other various…

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Posted and filed under FWA.

Top Recent Regulatory Activities by the US Government

Recently, the U.S. Government has been undertaking regulatory activities to drive down healthcare costs and improve patient outcomes. It is crucial to keep an eye on published regulations. One of the Centers for Medicare and Medicaid Services’ (CMS) key goals is to pay claims right the first time. This means paying the right amount to…

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Posted and filed under Compliance, Healthcare.

What to Watch Out For With Credit Balance

In May 2014, the Department of Health and Human Services, Office of Inspector General (OIG) published a proposed rule updating its regulations. The proposed rule will authorize civil monetary penalties for “failure to report and return a known overpayment,” among other issues.   The rule has outlined the penalty for failure to report and return overpayments…

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