In today's healthcare landscape, ensuring compliance with the Americans with Disabilities Act (ADA) is crucial to providing inclusive and accessible services for all patients. Individuals with disabilities continue to lack equal access to routine preventative medical...
In the wake of the COVID-19 pandemic, the behavioral health industry finds itself under an intensified magnifying glass, with notable increased interest and activity from the Private Equity community and consolidation in the behavioral health space, it’s no...
Risk Adjustment (HCC) coding compliance is quickly becoming the forefront of primary care across the nation as value-based care models continue to be implemented within the healthcare industry. With the added administrative burden placed upon providers and...
I have been actively engaged in healthcare compliance for the last 25 years. Over that time, I have frequently heard the complaint that compliance is a costly nuisance. Why is it so expensive? Is there a way around it? Who pays for this unfunded mandate? I’ll let you...
The healthcare industry, and physician practices in particular, are experienced at weathering industry disruptors and a landscape that seems to be in perpetual change. However, the last few years have seen a notable increase in mergers and acquisitions, with all...
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...
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...
These are recaps of what they report as some of the trends and realities of compliance today
The innumerable horror stories related to payer audits have given rise to a new trend of undercoding, by intent! Many providers would rather be safe than sorry, all in the name of keeping their good names off the radar. However, undercoding can backfire, resulting in...
The 21st Century Cures Act ("Cures Act") was approved by Congress in 2016 with the intent to provide electronic access, exchange, and use of health information across all different types of health care entities. On May 1, 2020, the Cures Act's final rule became...