Fraud, Waste, and Abuse

Performance Improvement Plan

Are You Prepared for the HIPAA Phase 2 Audits?

After reviewing the HIPAA Privacy case investigations from 2009-2011, the Office of the Inspector General sent a strong message to the Office of Civil Rights in regard to the administration…
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,…
Healthcare Compliance - Medicare

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…

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…