Healthcare Compliance -Claims and Procedures

Billing Care Plan Oversight Risks

Care Plan Oversight describes the physician or other healthcare professional’s supervision of patients in hospice, nursing facilities or those receiving care through home health agencies. CPO reimbursement covers initial certification,…

Are You Aware of the Whistleblower Provisions of the False Claim Act ?

The whistleblower provisions of the False Claims Act have lead to several newsworthy cases in recent years. Just a few days ago, the Justice Department announced that KMART Corporation (Kmart)…

Complying with Stark Law: Can you bill Medicare when treating your family members?

The treatment of family members falls under General Exclusions from Coverage under Medicare. No payment will be made for items or services for a family member when the charge is…

LEIE: Do You Know About the List of Excluded Individuals and Entities?

The Exclusions Statute is one of five major federal fraud and abuse laws. Exclusion is an administrative remedy that is in the form of a penalty imposed on a provider.…

How would your staff react to an auditor or investigator?

Audits and investigations are stressful events either with or without prior notice. Medical staff should be prepared for an unannounced visit. First Healthcare Compliance provides a sample policy that assists…

Avoiding Overutilization vs. Patient Satisfaction: What’s a provider to do?

An increasingly important issue for many providers is the dilemma of providing care that is satisfactory to the patient while avoiding overutilization and its effect on reimbursement. Unfortunately, the patient’s…

Healthcare Compliance Solutions and News

Are you trying to prevent medical identity theft?

Medical identity theft continues to be major problem in the US with approximately 2.32 million adults or close family members falling victim in 2014. According to the Fifth Annual Study…

$22 M of Potential Fraud, Waste and Abuse Discovered in 2012 Medicare Ophthalmology Claims

In 2012, approximately 49 million Medicare claims were related to screening, diagnosis or treatment of cataracts, wet acute macular degeneration and/or glaucoma. Medicare paid approximately $3.5 billion for these particular…

What Should You Do After Discovering a Billing Error?

Just correct the problem and you will be compliant? No, but this is the first step in the right direction. According to the HHS in “A Roadmap for New Physicians…

Testimonials

Mary Ann Tyler, Practice AdministratorSinclair Retina Associates, PC, Media, PA
Compliance in all areas always seemed to take a back seat to day to day operations. First Healthcare Compliance has developed a solution that easily brings any size office into compliance. It gives me peace of mind.
Kris Jones-Bartley, CPCPresident,
Healthcare Management System
The First Healthcare Compliance solution allows our business and our clients to save time and money, and mitigate compliance risks. I highly recommend it to other healthcare billing companies.
Neil S. Kalin, MDKalin Eye Associates, Newark, DE
I’d been searching for a compliance plan for many years. The First Healthcare Compliance solution is cost-effective and efficient. All of the compliance materials are in one place.
Dr. Marc D. Grobman, DO FACPInternal Medicine & Primary Care, Wilmington, DE
Using this solution, I am confident that I am meeting the guidelines or that I can seek help for areas in which I cannot perform the requirements on my own.
Paul Smiley, NHAAdministrator, Gilpin Hall
The First Healthcare Compliance solution offers a simple and effective centralized system to access and assemble our compliance data with minimal effort and maximum return. I highly recommend it!
Robert Henry, PA-C, CEOAmbient Care, Seaford, DE
In an era of ever changing regulations, First Healthcare Compliance has given us the tools to seamlessly and efficiently stay on top of our compliance requirements. This allows us more time to focus on patient care and other aspects of practice management.
R.K. Conell, Practice ManagerAlexiou Hearing and Sinus Center, PLC and Harrisonburg Dermatology, PLC, Harrisonburg, VA
The First Healthcare Compliance solution has everything you need to get started. It helps a practice become compliant on a very timely basis. Without this, it would have been a very extensive and intensive process.
Anne Elkin, EsquirePractice Manager, Boothwyn Medical Associates
The solution has been a great help to our practice. We can now organize all our compliance data in one place.

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