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...
HHS’s Cyber Security Efforts Examined by Subcommittee on Health
Recently, a number of hospital computer systems have been hacked and the hackers demanded ransomware. Wichita-based Kansas Heart Hospital is one of the hospitals that decided to pay the “small” ransom after the hackers locked files, a decision that the FBI does not recommend. This latest cyber-attack occurred just one week prior to...
Medicare and Medicaid Program Integrity
On May 24th, the Subcommittee on Oversight and Investigation held a hearing entitled “Medicare and Medicaid Program Integrity: Combatting Improper Payments and Ineligible Providers.” The hearing was held based on recent reports from the Government Accountability Office (“GAO”) and the Department of Health and Human Services (“HHS”) Office of the...
Staying Up-To-Date on MACRA
This past week, the Acting Administrator of the Centers for Medicare & Medicaid Services (CMS) took to social media to provide 4 Key Takeaways on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the comment period: Reminder that providers have the opportunity to invite representatives from CMS...
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....
Announcing Provident’s 2016 Healthcare Compliance Webinar Series
Provident is pleased to announce the 2016 healthcare compliance webinar series. Join Provident as we host complimentary 30-minute, lunch break webinars aimed at keeping you and your organization informed on the latest happenings in the healthcare world. 2016 is the year of compliance! Starting with our kickoff webinar in May, the...
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...