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 clients in preparing the front office. Here are some recommendations to ensure that proper steps are taken: Immediately contact your supervisor, manager and/or Compliance Officer

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 perceived satisfaction may not be a result of receiving the best quality of care and in some cases may be due to inappropriate or wasteful

How do you fire a patient?

Obviously, no one wants to terminate a patient, but sometimes it is reasonable and in the best interest of both parties.  There are circumstances when it may be within the rights of the provider and appropriate to terminate a patient. Some examples include a patient who: -No-shows or cancels appointments frequently or repeatedly -Does not

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 on Medical Identity Theft by the Ponemon Institute, medical identity theft is on the rise with a 21.7% increase since last year.      

Are You Billing for Home Care Visits?

Physician home visits are under scrutiny by CMS for any possible fraud. In 2012, Medicare paid home care service providers about $236 million. As the population of Medicare age recipients increases it seems likely that the need for home care services will also increase. There are many benefits to providing home care services such as

Is your staff practicing hand hygiene that complies with your policies and procedures?

Compliance with hand hygiene is one of the most important ways to prevent spread of infection. In the United States about 1 in 25 hospital patients a year acquire an infection during their hospital admission. Transmission of pathogens can potentially occur at many points of contact with the healthcare provider. Best practices for hand hygiene

ICD-10 – Preparation for Your Practice

The Department of Health and Human Services (HHS) delayed the original compliance date of October 1, 2013 until October 1, 2014, to allow the continued preparation necessary to be ready for the largest transition in our Healthcare reimbursement system. This transition requires business and system changes in order for the Healthcare reimbursement systems to be

Avoid OSHA Violations In Your Medical Office

Under the Occupational and Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees.  According to Robert Kulick, OSHA regional administrator, employers and employees must work together to identify and eliminate potential hazards. A serious OSHA violation occurs when there is substantial probability that death or serious

Protecting Your Practice is Smart Business

Doctors playing defense The government cites defensive medicine as a factor in the escalation of health care costs. However, a recent study indicates that 73% of physicians engage in some form of defensive medicine. The payers’ perception of defensive medicine is negative, but the providers’ view it as a necessary evil in today’s environment. Medical