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:  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...

It has been more than a year since ICD-10 was implemented, which has allowed for some degree of normalization for clinical documentation improvement (CDI) programs. Time and resources can now be redirected towards building, strengthening or expanding CDI programs to meet the increasing demands of documentation requirements. Below are three...

Over the past year, reports of Protected Health Information (PHI) breaches, ransomware attacks and hacking of healthcare software systems/applications have increased. Due to the uptick in potential breaches and threats to PHI, the Office of Civil Rights (OCR) has also increased its efforts to ensure healthcare organizations have the appropriate...

The Health Information Management (“HIM”) department is the informational and financial hub of healthcare facilities. Coders, clinical documentation specialists (“CDS”) and quality/compliance analysts are the last line in an important workflow that determines a facility’s reimbursement.  An HIM directors’ responsibilities go beyond making sure things just run smoothly.  A successful...

Mobile Healthcare IT Adoption: Strategies to Secure Physician Engagement According to the 2016 Red Hat survey, investment in mobile applications by healthcare organizations are paying off, with 78% of organizations surveyed reporting a positive return on their investment.   With these positive returns, adoption of mobile healthcare applications is only expected...

Recently, the Supreme Court (“the Court”) considered whether whistle-blowers and the government should be allowed to bring False Claims Act (“FCA”, “the Act”) cases under the implied false certification theory. In a unanimous decision in Universal Health Services, Inc. v. United States ex rel. Escobar et al. (“Escobar”) issued on...