“Revenue cycle management compliance is crucial for the financial health and operational success of healthcare providers. By adhering to regulatory standards, ensuring accurate billing and coding, and protecting patient information, healthcare facilities can avoid legal repercussions and maintain patient trust.”
Continue readingHow to Properly Use the G2211 Evaluation and Management Code
“Code G2211, which can be added to specific E/M codes under certain circumstances, is now separately reimbursable by Medicare.”
Continue readingThe Cost of Non-Compliance
“The cost of non-compliance in healthcare extends far beyond fines and penalties. It encompasses legal fees, reputational damage, operational disruptions, and more. Investing in compliance is not just a legal obligation—it is a critical component of a healthcare organization’s operational excellence and commitment to patient care.”
Continue readingReady, Set, Go! Identifying Emerging Risks in Your 2024 Compliance Workplan
“Before moving on from 2023, it is important to take time and get feedback from business partners to ensure an “outside-in” perspective is included in your 2024 plan.”
Continue readingKey Takeaways from OIG’s Newly Released General Compliance Program Guidance
“Successful compliance programs are adapted to fit the organization and maximize compliance for individual organizations with unique risk profiles.”
Continue readingThe Value of “Operationalizing” Your Compliance Program
“Regardless of the business model, there’s been one common reason why these organizations were successful in “operationalizing” their compliance programs: compliance priorities were aligned with business objectives and priorities. And the operations leaders bought in.”
Continue readingReversing Conventional Thinking About Compliance
Explore how compliance professionals can prove their true value in organizations, dispel misconceptions, and effectively mitigate risks. Real-world examples illustrate the tangible impact of robust compliance departments.
Continue readingNew, Stronger Evaluation and Management Upcoding Enforcement
“Earlier this year, regulators made the most significant changes to E&M documentation and coding guidelines in over two decades. They’re more complex than ever before, and enforcement actions are increasing.”
Continue readingIncreasing Enforcement of Modifier Codes
“Enforcement agencies like to “follow the money,” so to speak, and they often find it in medical claims submitted to government payors such as Medicare and Medicaid. This is why selecting appropriate modifier codes is essential for operating and being reimbursed compliantly.”
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