When evaluating a physician-practice acquisition, a deep dive into the financials of the target does not always tell the whole story. Without an examination of whether the coding and clinical [...]
In today’s fast-paced healthcare environment, efficiency and accuracy are non-negotiable. Every medical practice, hospital, and healthcare system strives to optimize revenue, ensure compliance, and deliver exceptional patient care. One area [...]
In today's complex healthcare landscape, maintaining coding compliance is more crucial than ever. Recent developments from the Department of Justice (DOJ), including the launch of the Corporate Whistleblower Awards Pilot [...]
On August 1, 2024, the U.S. Department of Justice (DOJ) launched its Corporate Whistleblower Awards Pilot Program. This initiative is a significant development in the DOJ's efforts to uncover corporate [...]
Navigating the complex labyrinth of HCC coding is a daunting task for healthcare providers due to the frequent carrier changes to rules and regulations, and non-compliance could mean substantial revenue [...]
Kaiser Permanente and members of its healthcare consortium defrauded Medicare of nearly $1 billion by tacking on diagnoses to patients’ medical records to earn more in reimbursement payments, the Department [...]
From a compliance exposure perspective, we believe that the HIPAA risk associated with sending PHI abroad is simply untenable. HIPAA is an American law that does not extend beyond our [...]
A troubling trend in the medical coding industry is a misleading split model where companies will have resources both onshore and abroad but not disclose which personnel are performing the [...]
CMS has delayed the start date of its Emergency Triage, Treat and Transport model from May 1 until this fall. CMS selected 205 participants in February for the five-year ET3 model. CMS said it [...]
A Texas physician was found guilty Jan. 15 for his role in a $325 million healthcare fraud scheme that involved falsely diagnosing patients with various degenerative diseases and then administering [...]
