While implementing an effective compliance program is not a guarantee of fraud, waste and abuse prevention, it does help mitigate the risk of improper conduct. One key element of an effective and successful compliance program is oversight and defined reporting. Below are tips to consider when implementing or evaluating the...
Insights
Clinical Practice Improvement Activities: Become a Top Performer in this MIPS Category
The Medicare Access and CHIP Reauthorization Act (MACRA) streamlines existing quality programs into one Quality Payment Program. Each year participants will choose from 90 clinical practice improvement activities and 300+ quality measures. They will also submit data that will feed 40+ resource use measures and advancing care information measures. Here...
Stop Notification Fatigue! Untether from the EHR Inbox
A study was recently highlighted in JAMA Internal Medicine on the burden of Electronic health record (EHR) inbox notifications. On average, primary care physicians received 77 notifications per work day and specialists received 29 notifications. The study observed 46 primary care physicians and 46 specialists using both Epic and Centricity...
Why Healthcare Organizations Should Conduct a Mock IRO
Independent Review Organization (IRO): Why Your Healthcare Organization Should Conduct a Mock IRO Assessment. While inherent to most Corporate Integrity Agreements (CIA), mock IRO assessments are becoming increasingly popular and proving advantageous to healthcare facilities not under a CIA. Conducting a mock IRO using the Office of Inspector General (OIG)-approved...
Query Integration (DocEdge QI™) with DocEdge™ Communicator
Communication between Physicians and Case Management, Coding, Quality and Clinical Documentation Improvement (“CDI”) staff is often fractured, with physicians receiving queries through multiple channels (email, paper, fax, phone) and in varied formats. Inconsistent query quality, complicated query processes, and limited EMR integration negatively impact physician response times. Physicians are frequently...
Get Ready for MIPS: A Step-by-Step Guide
Beginning in 2017, Medicare will start measuring performance under the Merit-Based Incentive Payment System (MIPS) program, as required by Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Here is what you need to do starting now to prepare for January 2017 to enroll, and be successful. Remember, what you...
Getting to Know Core Measure SEP-1: Early Management Bundle, Severe Sepsis/Septic Shock
Getting to Know Core Measure SEP-1: Early Management Bundle, Severe Sepsis/Septic Shock The new CMS Core Measure for sepsis (SEP-1) has drawn praise, criticism, and confusion. Providers, documentation specialists, and coders need to collaborate to ensure sepsis is properly documented and treated to ensure compliance with CMS Core Measure SEP-1....
How Effective is Your Organizations Compliance Program?
In recent years the healthcare industry has seen a tremendous push in its efforts to encourage organization(s) to develop effective internal controls to monitor compliance with State and Federal regulations. As hospitals and other healthcare organizations continue to face increased scrutiny, Provident has developed a checklist that can be used...