HealthCare Compliance Network
The Dos and Don’ts of Medical Payer Audits: How to Identify and Respond to Them
ABSTRACT Prior to the COVID-19 pandemic, medical providers were routinely audited by public and private payers. Since the pandemic, when many payers were forced to pay for expensive COVID-19 related testing and treatment, payer audits have increased. When a provider...
Back to Basics
The last two and a half years have been anything but business as usual for physician practices and healthcare organizations. From scrambling for PPE in the initial stages of the pandemic, to refitting offices and implementing processes to keep patients and staff safe,...
Lessons for Physician Practices from their Security Risk Assessment
Far too often, physician practices leave the heavy lifting of their Security Risk Assessment (SRA) to their IT team, IT vendor, or Managed Service Provider (MSP). It is true that much of the SRA focuses on technical safeguards, but it is critical that elements of the...
Healthcare Disruptors
Consolidation in healthcare is causing a lot of disruption and increasing Private Equity investment in the healthcare services space. Industry experts highlighted several disruptors facing the industry and shared insights to the future landscape that are key,...
2023 CPT Coding Changes
The following is a synopsis of the major changes to CPT that will take effect January 1, 2023.
2022 MIPS Risks – Are You Ready?
For the last few years, MIPS (Merit-Based Incentive Payment System) has been avoidable primarily due to COVID-19 and other hardships. However, 2022 seems to be the year when there is going to be pushback on the practices making it more difficult to get an exemption....
Compliance Due Diligence Comes of Age
The new necessity for healthcare acquisitions
Significant Evaluation and Management Coding Changes Again on The Horizon
In 2021, the American Medical Association implemented significant changes to the Evaluation and Management (E/M) code sets applicable in the office/outpatient setting. Those changes, which were intended to simplify coding by placing more emphasis on complexity and...
Challenges of Finding and Retaining Talent for Private Practices
As we have seen since April 2021, we are still being influenced by the Great Resignation or the Big Quit. COVID-19 was a wake-up call for many people in general, but even more so for employees who were not satisfied with their current roles in the workplace. Employees...