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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, 2009 - VIEW THE FULL ISSUE

• Use productivity benchmarks to set coding standards

  With audit contractors scrutinizing coding accuracy and an upcoming transition to the ICD-10 coding...

• Tips to tackle the top safety problems in your lab

  You know the common lapses: a forgotten lab coat, an overflowing trash can, an eyewash station...

• Harm thresholds: Opportunity for CEs to be more accountable for PHI, breach mitigation

  When HHS published its interim final rule on breach notifications in the August 24 Federal...

• Boost negotiating power with simple tips

  Negotiations raise two questions: Do you drive a hard bargain? Or do you typically slink away from...

Issue 11, November 1, 2009 - VIEW THE FULL ISSUE

• Experts: Expect more enforcement as Office for Civil Rights role expands

  “The move means a trigger has been pulled to be more aggressive with compliance actions and...

• Interim final rule: Timeline, breach summary will provide significant challenges for covered entities

  Adjusting to some of the new requirements will be difficult, but other aspects of the rule...

• New BA requirements call for new contract language

  Understanding the new risks, responsibilities, and requirements presents a complex challenge for...

• Modifier -59: Reduce risk, receive correct reimbursement

  To prevent compliance or revenue difficulties, education on modifier -59 is critical. Learn to use...

Issue 10, October 1, 2009 - VIEW THE FULL ISSUE

• The rising cost of a privacy breach

  The cost of a privacy breach far exceeds any fines authorized by the Health Information Technology...

• The ZPICs are coming

  This means that if there are problems with your billing processes, it’s more likely that your...

• Q&A: Hospice communication, home computer use, outgoing mail, and more

  Learn the answer to your important HIPAA privacy and security compliance questions.

• What would you do? Know your ethical obligations

  Coding ethics gets little attention because of more immediate concerns, such as keeping accounts...

Issue 9, September 1, 2009 - VIEW THE FULL ISSUE

• Create a culture of HIPAA compliance

  HIPAA may not be fun to teach, learn, or execute because of its complexity, but it needn’t be...

• Auditors: Watch out for coding compliance issues

  Auditors can ensure that coders are following regulations and policies by watching out for the...

• Stop readmissions when you can

  CMS data show that hospitals will readmit one in five patients who leave the facility today within...

• Q&A: Breach notification, summer help, HIPAA compliance

  Learn the answer to this and other challenging HIPAA compliance questions from your colleagues.

Issue 8, August 1, 2009 - VIEW THE FULL ISSUE

• Major privacy breaches: How to respond to their unique challenges

  the government, via the Health Information Technology for Economic and Clinical Health (HITECH...

• Case study: Create a culture of compliance

  In most healthcare environments, the HIPAA specialist has other responsibilities, and therefore...

• E/M auditing: Avoid denials and lost revenue with audits

  Whether a practice is small or large, E/M coding is an integral part of the revenue cycle. In 2002...

• Nine lessons from the RAC demonstration program

  Tracking appeals is the single most important way to survive a RAC audit because it allows you to...

Issue 7, July 1, 2009 - VIEW THE FULL ISSUE

• HCCA Compliance Institute roundup: OIG illustrates five principles of compliance

  With an entire generation of baby boomers getting ready to sign up for Medicare, the OIG is gearing...

• Risk and reward: Assess vulnerabilities now; avoid breaches later

  Risk assessment is an important and necessary task for every ¬organization. It can mean the...

• California’s hospital quality data reporting success

  These days, “quality” and “care” are buzzwords.

• Compliance update: FTC moves Red Flags Rule compliance deadline to August 1

  The FTC announced in early May that it has delayed enforcement of the rule. This delay will give...

Issue 6, June 1, 2009 - VIEW THE FULL ISSUE

• HITECH Act: Eight experts weigh in

  It’s been nearly five months since President Obama signed the American Recovery and...

• Medical necessity important element of audits

  Every audit has unique components to check depending on whether you audit a certain department, a...

• ED auditing includes many components

  Among the chaos of the emergency department (ED) lie several unique compliance challenges and...

Issue 5, May 1, 2009 - VIEW THE FULL ISSUE

• Mark it down: Red flags rule compliance deadline is May 1

  There were 10 million victims of identity theft in the United States in 2008, a quarter of whom...

• E/M service claims: Know compliance risks before auditing

  E/M services include several complex components and categories, which in turn present compliance...

• Anesthesia audits call for prior research

  Proper documentation by the anesthesiologist or certified RN anesthetist (CRNA) drives correct...

• Experts: HIE guidance just a framework for successful compliance

  SHCC asked two experts to weigh in on what providers can take away from the recent OCR guidance on...

Issue 4, April 1, 2009

• Get administration, board members on board with compliance program

  Have an idea you want to pitch to the board? Here are a few ways to get started.

• Mark your calendar: ICD-10 effective October 1, 2013; Start your transition now

  The first year of a plan to get ready for ICD-10 should focus on the fundamentals, such as a staff...

• Prepare for new OSHA, Joint Commission standards

  Take a look at new OSHA regulations affecting labs and their hazardous gas monitoring, emergency...

• Make Stark compliance a priority this year

  Provisions to the Stark Law will be effective October 1. We analyze its major components.

• Don't forget about Medicaid: 2009 OIG Work Plan highlights compliance concerns

  Providers must look ahead to protect themselves against the kind of Medicaid abuses the OIG looks...

Issue 3, March 1, 2009 - VIEW THE FULL ISSUE

• Create a compliant on-call payment model

  A shortage of on-call physicians makes it more important than ever to find an on-call payment model...

• Tackle privacy training challenges in physician offices; ensure compliance with HIPAA guidelines

  Inside their physicians’ offices, patients can often get the personalized care they might...

• Address data encryption in 2009

  Eat better, go to the gym more often, and take up a hobby; these are all fine New Year’s...

• Protect your organization's wallet: Comply with PCI DSS

  On October 1, 2008, the Payment Card Industry (PCI) Security Standards Council (SSC) updated its...

Issue 2, February 1, 2009 - VIEW THE FULL ISSUE

• No compliance worries here

  With the government stepping up its efforts to combat Medicare and Medicaid fraud and abuse...

• MS-DRGs are on the OIG’s radar

  The OIG’s 2009 Work Plan states that the OIG will “examine coding trends and patterns...

• Quality control, compliance in the genomics era

  Genomics-based technologies are front-page news in the mainstream media, thanks to companies...

• Step up HIPAA compliance through auditing measures

  With the focus on enforcement increasing in many areas of healthcare compliance, auditors need to...

• Q&A: HIPAA breach notification, secure e-mail, and more

  Q. Do big screens mounted in an operating room (OR) or emergency room (ER) that display patient...

Issue 1, January 1, 2009 - VIEW THE FULL ISSUE

• Tips for a successful switch to electronic health records

  EHRs, like iPods and other digital music players, make thousands of files readily available in one...

• Quality of care is top priority in 2009

  The OIG has a pretty aggressive work plan, according to some experts who spoke to HCPro, Inc. It...

• Chargemaster maintenance is worth it

  With slim margins and the risk of denials or loss of revenue from using incorrect codes, laboratory...

• Increased focus on quality calls for more queries

  Incorrect coding of a postoperative complication could result in a complication and comorbidity...