Insights

Guidance on How It Determines the Effectiveness of a Compliance Program

The Department of Justice Issues Guidance on How It Determines the Effectiveness of a Compliance Program Recently, the Department of Justice’s (“DOJ”) Fraud Section released guidance entitled “Evaluation of Corporate Compliance Programs,” (“Compliance Memorandum”), which highlights how federal prosecutors investigate the adequacy of an organization’s compliance program during a criminal investigation....

What Is Your Organization Doing to Prevent MACRA-Related Penalties?

If you are one of the many healthcare providers/organizations baffled by the intricacies of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and have not taken action – you still have time. It is imperative that you participate at some level in 2017 to avoid potential penalties of...

Coding and Documentation Compliance Series

Provident’s Coding and Documentation Compliance Series featured three (3) webinars focused on documentation standards, coding best practices and ways to ensure inpatient hospital based reimbursement aligns with the care being provided. The third webinar in the series, ICD-10 DRG Audit Target Areas includes the following case studies: o Sepsis o...

2017 ICD-10 DRG Audit Target Areas

Excisional Debridement 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...

OBTAINING VISIBILITY INTO OUTPATIENT RISKS AND OPPORTUNITY

The expansion of outpatient services continues to be a high priority for hospitals across the country.  What continues to drive this transition?  Value-based reimbursement models and patient demand. The proof is in the numbers – in 2013 there was an average of 2,145 outpatient visits per 1,000 people up from...

CDI QUERY OPTIMIZATION

CDI Query Optimization with DocEdge® Communicator The administrative burden on providers has only increased over the past several years due to the implementation of multiple federal government driven regulations and performance improvement programs. According to a recent study published in JAMA, primary care physicians receive 77 EMR notifications per full...

DocEdge Enhances Query workflow

An interview with DocEdge Communicator Users We recently sat down with one of Provident’s DocEdge® Communicator clients to learn more about how DocEdge® Communicator has impacted their query workflow.  Here is what the Clinical Documentation Improvement Specialists had to say after using DocEdge® for over a year. 1. How has...

2017 ICD-10 DRG AUDIT TARGET AREAS

 COPD Exacerbation with Pneumonia 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....

Effective Written Policies and Procedures

Having an effective compliance program is critical for healthcare providers given today’s complex regulatory environment and increased scrutiny of by federal and state regulators.  One core element of an effective compliance program is written policies and procedures.  Written policies and procedures describe the compliance program’s expectations, provide guidance to employees...

Artificial Intelligence in Healthcare Management

Artificial Intelligence in Healthcare:  AI moves from sci-fi movie plots to real world applications for coding, patient care and health management and strategy. Artificial Intelligence (AI) is ‘machine learning’ and the ability to perform tasks without human direction. Cognitive tasks include speech and visual interpretation, decision-making, problem-solving and complex data...

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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.

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