Insights

Opportunity in the Data

How does your healthcare organization identify opportunity/areas of risk? Is a consistent methodology applied? Is data shared among departments? How do you loop in providers/educate? In our experience, healthcare organizations spend a lot of time and resources on the back-end revenue cycle process. With the back-end focus to drop the...

Elements of Success for Improve Quality and Shared Savings

In contradiction to Centers for Medicare & Medicaid Services (CMS) data, recent studies show that the Medicare Shared Savings Program (MSSP) has generated $1.84 billion in savings from 2013 – 2015 and reduced Medicare spending by $542 million.  How will this data impact the recent CMS proposal to overhaul MSSP...

Accountability through Auditing

Recently, the government determined that a North Carolina hospital failed to comply with Medicare billing requirements for 29% of the cases reviewed in the sample.  Using extrapolation, the government is requesting the hospital repay over $700,000 in overpayments.  In addition to the repayment, the government included other mitigation strategies that...

Define and Expand Your Mobile Strategy

A recent annual survey of over 300 healthcare professionals across the country asked questions about how mobile policies are adopted and enforced and plans for extending mobile technology.  Overall, the survey responses indicated that current policy is primarily focused on the use of mobile devices versus defining and expanding mobile...

Do Frequent Interruptions Impact Physicians? Patients?

Most organizations are acutely aware that clinicians spend increasingly more time at the computer with the evolution of electronic health records and other data capture databases. But, has your organization asked any of the following questions? How much time do your clinicians spend on average using EMR or other databases?...

2018 ICD-10 DRG Audit Target Area – Cerebral Edema

Provident has been engaged in ongoing DRG audits since ICD-10 was implemented in October 2015. We have identified potential DRG audit target areas related to our audit work, changes to the ICD-10 codeset, and Coding Clinic updates. We will be posting cases regularly in our newsletter. Please see this edition’s...

Telehealth Services – Proactively Assess Your Risk

In a recent review of telehealth services, the Office of Inspector General (OIG) found approximately one-third (31/100) of the claims reviewed did not meet Medicare telehealth requirements.  Of the 31 cases, the majority were noncompliant because the patients received care in a location not considered “rural.”  Institutions/facilities that provide telehealth...

About Us

Leveraging our deep operational experience and real world understanding of the regulatory landscape, Provident partners with our clients to meet the diverse challenges of the evolving healthcare industry. With proven solutions, expertise, innovative thinking, and specialized tools and techniques the Provident team works collaboratively with clients to optimize their financial and operational performance.

Newsletter Sign-Up