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Q&A: CERT Findings and Proper Monitoring

Pam Joslin, MM, CMC, CMIS, CMOM, CMCO, CEMA, CMCA-E/M, CEO, with Innovative Healthcare Consulting, presented the webinar ‘Understand CERT (Comprehensive Error Rate Testing) Findings and What Your Organization Should Be Monitoring.’ Ms. Joslin addressed many common questions and we’ve highlighted the top Q&A.

By |October 18th, 2018|CMS|

CMS Updates Compliance Program Training Requirements for FDRs

Establishing and maintaining a well-designed compliance program is key to preventing, detecting, and mitigating noncompliance. The seven elements of an effective compliance program outlined in the Federal Sentencing Guidelines, adopted by the Office of Inspector General (OIG),  sets the framework but there are additional requirements that need to be integrated into the compliance program in

By |October 11th, 2018|CMS|

Is your practice ready for the new Medicare Beneficiary Identifier?

Preventing identity theft continues to be a major focus of the Social Security Administration and the Center of Medicare and Medicaid Services (CMS). Beginning April 2018, Medicare cards will no longer contain Social Security Numbers (SSN) as part of the Social Security Number Initiative (SSNI) and Medicare Access and CHIP Reauthorization Act (MACRA). Instead, Medicare

CMS Emergency Preparedness Program

The CMS final rule on Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers is in effect! View our infographic to learn more about the emergency preparedness program and its components.

By |November 30th, 2017|CMS|

Updates to the Quality Payment Program

On November 16, 2017, the Centers for Medicare and Medicaid Services (CMS) is expected to publish the final rule to address updates to the Quality Payment Program (QPP).  The new “Patients Over Paperwork” initiative provides for streamlining with goals of reducing unnecessary burden, increasing efficiencies, and improving the beneficiary experience. This effort emphasizes a commitment

Avoid Denials and Mitigate Risk Under the CMS CERT Program

Insufficient documentation is by far the most common reason for denying a claim or improperly paying a claim. Improperly paid claims become problematic after identification by the Center for Medicare and Medicaid Services (CMS) Comprehensive Error Rate Testing (CERT), a random sampling of claims evaluated for compliance with Medicare coverage, coding and billing rules.  

CAHPS for MIPS Survey

CMS announced their 2017 CAHPS survey, and time is running out for providers to submit their participation applications. Qualified applicants will be awarded points toward their MIPS status. Review our infographic to learn more about the survey process!

By |April 27th, 2017|CMS|