Insights

Do you know the new Sepsis Criteria?

The clinical criteria for sepsis and septic shock has been redefined per an article published in the Journal of the American Medical Association (JAMA February 23, 2016). The new criteria is called SOFA (Sepsis-related organ failure assessment), which is a scoring system used to determine the extent of a patient’s organ function...

9 best practices towards an effective Enterprise Risk Management Program

An enterprise risk management (ERM) program identifies, assesses and quantifies risks posed to an organization. An effective Enterprise Risk Management program utilizes a cross-cutting methodology to prioritize identified risks in addition to finding ways to mitigate, control and monitor them. Provident has identified lessons learned and best practices from developing, assessing and...

Healthcare Check Up: The Importance of Internal Audit & Compliance Program Assessments

With the sea of ever changing healthcare regulations it is important that organizations conduct regular and ongoing internal audit and compliance program assessments. Within the last decade the healthcare arena has witnessed sweeping regulatory changes, including: Compliance with the Patient Protection and Affordable Care Act (PPACA), Implementation of International Classification...

UNDERSTANDING YOUR READMISSION RATES

Between 2007 and 2015, hospital readmission rates for more than 3,300 US hospitals dropped significantly according to new federal data. During the same time period, the number of Medicare observation claims slightly peaked. Is there a connection? It depends on the research you read. No connection – A recent study...

12 Questions You Need to Ask to Maximize Audit Results

“CFOs and other executives often have little visibility into the results; even those that seriously impact revenue.” As CFO, the financial health of an organization rests on your shoulders. You identify growth opportunities and watch for payer and government activity that tighten the organizations purse strings. Whether your view is...

ICD-10 Coding Accuracy

With ICD-10 go-live in the rear view mirror it is still imperative to look at the road ahead.  Provident has been working with its clients to monitor and identify trends in ICD-10 coding to ensure the transition to ICD-10 remains as seamless and effortless as it was on October 1,...

HIPAA Enforcement: Administrative Law Judge Rules in Favor of OCR Enforcement

“Under HIPAA, Respondent was obligated to take reasonable steps to protect its PHI from theft.” On January 13, 2016, an Administrative Law Judge (“ALJ”) ruled that Lincare, Inc. (“Lincare”), a home health company, violated the HIPAA Privacy Rule. Lincare was ordered to pay $239,800 in civil money penalties (“CMPs”) imposed...

Supreme Court Case Regarding False Claims Act Could Have Major Implications for the Healthcare Industry

“The American Medical Association argues in its brief that imperfect compliance is not the same as fraud” Healthcare organizations across the Country, including the American Medical Association, are joining the Supreme Court case Universal Health Services v. United States ex rel Escobar, the outcome of which could heavily impact the...

Show Me the Record: The Importance of Good Clinical Documentation

ICD-10, Meaningful Use and integrity/quality initiatives have recognized the need for and contributed to the impetus for improved clinical documentation.  Good clinical documentation is a critical element in delivering patient care.  Complete and accurate documentation validates the care provided shares key data with subsequent caregivers and allows coders to code...

Dual Coding: The Key to a Successful ICD-10 Transition

As the official implementation of ICD-10 approaches, healthcare organizations are finalizing plans for managing this transition. One key initiative to prepare for ICD-10 is to implement dual coding. There are many benefits to dual coding beyond providing coders an opportunity to practice including: identification of remediation training needs, minimizing productivity...

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.

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