by Advize Admin | Mar 17, 2017 | Coding, Compliance, Fraud
Physicians and their billing/coding staff have an established history with, and an acute awareness of upcoding and overpayments. In fact, unless they’re operating within a fraudulent billing scheme, they’re avoiding the practice of upcoding all together. Upcoding is...
by Advize Admin | Jan 5, 2017 | Compliance, Healthcare
The Health Insurance Portability and Accountability Act (HIPAA) has a primary goal of protecting the confidentiality and security of healthcare in formation, and has established standards for electronic data interchange (EDI). HIPAA is celebrating its twenty-first...
by Advize Admin | Dec 27, 2016 | Coding, Compliance, Healthcare
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...
by Advize Admin | Aug 18, 2016 | Coding, Compliance
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...
by Advize Admin | Jul 14, 2016 | Compliance, Cybersecurity
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...
by Advize Admin | Jun 30, 2016 | Compliance, Fraud, Healthcare
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...
by Advize Admin | Jun 21, 2016 | Compliance, Healthcare
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...
by Advize Admin | May 3, 2016 | Compliance, FWA
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....
by Advize Admin | Apr 1, 2016 | Business, Compliance
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...
by Advize Admin | Mar 29, 2016 | Compliance, Healthcare
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...
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