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News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance will be your guide for avoiding fraud and maintaining compliance.

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Strategies for Health Care Compliance

Issue 12, December 1, 2007 - VIEW THE FULL ISSUE

• Take a closer look at patient amendments to guarantee compliance

  HIM departments are faced with the difficult task of handling patient amendments to medical...

• Complications arise with domestic abuse and PHI disclosure rules

  Healthcare providers are faced with new challenges regarding domestic abuse. The complicated...

• An increasing focus on patient-centered care

  The healthcare environment is being altered by a movement toward patient empowerment. Consumers are...

• Sort out disclosures with new privacy tool

  A new resource will help public health professionals understand the intricacies of HIPAA and other...

• Coding Q&A

  Sandy Sillman, RHIT, PAHM, DRG, coordinator for Henry Ford Health System in Detroit, answered the...

Issue 11, November 1, 2007 - VIEW THE FULL ISSUE

• Stark II Phase III released

  CMS has published the third and final rule (Phase III) of the Stark law regarding the self-referral...

• Develop dashboards for quality improvement

  To build an effective quality improvement (QI) dashboard, first gather a few pertinent indicators...

• The Joint Commission adds hand hygiene to NPSGs

  In June, The Joint Commission (formerly JCAHO) released its 2008 National Patient Safety Goals...

• Assess pay-for-performance readiness at your facility

  Conduct a readiness assessment to help your organization define a joint mission and vision around...

• Review policies, procedures for EHR subpoenas

  If your facility plans to replace traditional paper records with electronic document management...

• Train sales staff in compliance concerns

  Have you trained your sales staff yet this year? It is important to continually train employees...

Issue 10, October 1, 2007 - VIEW THE FULL ISSUE

• Manage subpoenas with a clear legal record definition

  As providers replace traditional paper records with electronic document management systems (EDMS...

• Don't be shy: Three strategies to bring staff members closer

  Getting compliance, laboratory, and finance personnel in the same room can build a sense of...

• Don't neglect HIPAA when renovating or rearranging

  Healthcare organizations considering renovating or adding new facilities should think about HIPAA...

• Q&A: How to handle transfer of electronic information

  Q&A: How to handle transfer of electronic information

• Watch for incorrect use of DRG 468, 477

  Terminology, semantics, alternative verbiage-the bane of a coder's existence! I had the...

• Virginia system tackles A/R through registration quality

  It was only four years ago when Teresa Bassett became the patient access director at Riverside...

Issue 9, September 1, 2007 - VIEW THE FULL ISSUE

• Health system's new vendor policy stands its ground

  If you've attended a healthcare compliance conference within the past year, chances are you've...

• Q&A: Subpoenas and reporting

  Q&A: Subpoenas and reporting

• Precertification presents anti-kickback problems

  More and more insurers require that physicians obtain precertification, or preauthorization, for...

• There are no excuses when it comes to the present-on-admission indicator

  Dear colleagues, Hospitals are going nuts with the upcoming implementation of the...

• Tips to help tackle inpatient psych challenges

  Inpatient psychiatric facilities (IPF) have their own reimbursement and compliance challenges...

• Build HIPAA into your overall compliance program

  One way to save time and money is to integrate your HIPAA compliance program with your...

Issue 8, August 1, 2007 - VIEW THE FULL ISSUE

• OIG targets hospitals' vendor-rebate reporting

  If you peruse the OIG audit-report notifications that appear frequently in your e-mail inbox, you...

• Beware: Baby Boomers are headed your way

  It's time to batten the hatches, as what some are referring to as the next "tidal wave" in...

• Increase efficiency, ensure compliance with a more organized medical record

  During a 2005 Joint Commission survey, Bon Secours Saint Mary's Hospital in Richmond, VA, realized...

Issue 7, July 1, 2007 - VIEW THE FULL ISSUE

• Ensure HIPAA compliance in the long-term care setting

  All covered entities face the task of HIPAA compliance. However, long-term care (LTC) facilities...

• Follow these tips to comply with the Deficit Reduction Act

  When the Deficit Reduction Act (DRA) became law in February 2006, healthcare providers' workloads...

• CMS proposes switch to MS-DRGs in 2008

  In its proposed rule updating the hospital inpatient prospective payment system (IPPS) for fiscal...

• Recovery audit contractor project goes national

  Hospitals that have paid little attention to the recovery audit contractors (RAC) demonstration...

• Provisions address signatures on requisitions and orders

  Although a test requisition doesn't need a signature unless a payer (e.g., Medicaid) requires it...

Issue 6, June 1, 2007 - VIEW THE FULL ISSUE

• Audit your facility's ambulance rates to prevent inappropriate discounts

  Swapping is one of the newest enforcement risks facing hospitals and other healthcare facilities...

• CMS still fine-tuning changes to severity-adjusted DRGs

  Although CMS is moving toward a severity-adjusted diagnosis-related group (DRG) system for fiscal...

• CMS issues HIPAA security guidance for covered entities

  It's time to dust off and update your security policies regarding the use of laptops and other...

• Help your hospital's compliance by using specialized IR staff

  Mary Washington Hospital in Fredericksburg, VA, has a busy catheter lab where physicians perform...

• Most stringent rules apply for new restraint regulations

  Hospitals that want to comply with CMS' new restraint and seclusion regulations, which took effect...

Issue 5, May 1, 2007 - VIEW THE FULL ISSUE

• Review coder compliance with diabetes guidelines

  Diabetes coding brings plenty of documentation challenges. Verify that coders are aware of the...

• HIPAA privacy violations continue despite provider efforts to train staff

  Use processes, audits to ensure success More than three years after the privacy rule's...

• Use audits to help physicians avoid median coding

  Editor's note: This story was written by Michael G. Calahan, PA, MBA, CCS-P, CPC, CPC-H, BAMC-OP...

• Groups call for NPI compliance contingency period

  But don't expect announcement right away Most providers will not be ready for the May 23...

Issue 4, April 1, 2007 - VIEW THE FULL ISSUE

• Check for compliance with new record-retention rules

  Dust off that old record-retention policy. The U.S. Supreme Court has made changes to the Federal...

• Despite cost, organizations take on documentation-improvement efforts

  Editor's note: The following article reports on the results of two HCPro, Inc., surveys that asked...

• Health system nixes freebies, implements strict rules

  The Henry Ford Health System in Detroit will no longer accept free gifts, lunches, and other perks...

• Hospitals must overcome physician resistance to P4P

  Proponents of pay for performance (P4P) say its benefits include cost reductions, fewer errors, and...

• Refocus your HIPAA training efforts for physicians

  It isn't news that many physicians are busy and uninterested in HIPAA-which can make training them...

• New ED G codes leave some questions unanswered

  Hospitals that have a fast-track emergency department (ED) within their standard, 24-hour ED may...

Issue 3, March 1, 2007 - VIEW THE FULL ISSUE

• Profiling data depend on accurate documentation

  You're probably aware that earning the appropriate reimbursement depends heavily on physician...

• Be wary of radiology, cardiovascular 2007 CPT Manual changes

  If you haven't already notified your radiology or cardiovascular departments of this year's CPT...

• Raise the bar on HIPAA compliance with security metrics

  Use measurable, objective goals to improve performance The good news-you have a robust security...

• The RAC project: Its effect on one hospital system

  Editor's note: This article is the second in a two-part series. Last month, SHCC looked at an...

• Not getting correct reimbursements?

  Experts offer reasons to challenge regulations Congress. The OIG. Fiscal intermediaries (FI...

Issue 2, February 1, 2007 - VIEW THE FULL ISSUE

• Secondary diagnoses: How much reporting is too much?

  When it comes time to make sense of the plethora of conditions sometimes listed in physician...

• Tips to keep your organization out of hot water and in compliance

  Fraud lawsuits involving major players in the healthcare industry (e.g., UnitedHealth, HealthSouth...

• The RAC project: Is it coming to a state near you?

  Editor's note: This article is the first one in a two-part series. In May 2005, CMS launched the...

• What the Deficit Reduction Act means for laboratories

  All laboratories should pay attention to the Deficit Reduction Act of 2005 (DRA) and understand...

• Security compliance depends on successful training

  The HIPAA privacy and security rules require that your organization adopt a variety of policies and...

Issue 1, January 1, 2007 - VIEW THE FULL ISSUE

• Audit pharmacy charges to recover lost facility revenue

  Incorrect pharmacy charges and units of services are a frequent source of lost revenue for...

• Develop FCA training language

  Many healthcare experts are advising providers to educate employees about the False Claims Act...

• Work Plan: Use the OIG as your hospital's guide

  With the arrival of the 2007 OIG Work Plan, it's time for you to begin developing your own work...