Maintaining the Health of Your Radiology Information System (RIS)

A healthy RIS is a critical component of a healthcare facility. Make sure that yours is working the way it should to avoid lost reimbursement and reduce the risk of compliance issues.

Exclusion Screening Requirements for Healthcare Entities: Ensuring Compliance and Protecting Your Organization

In the ever-evolving landscape of healthcare regulations, one crucial aspect that healthcare entities must prioritize is exclusion screening.

The Top 3 Compliance and Auditing Mistakes and How to Avoid Them

Compliance and auditing offer an opportunity for continuous improvement. Done right they help organizations better serve patients, mitigate risk and exposure, and improve reimbursement and revenue. But what constitutes doing it right? This article discusses the three most common mistakes.

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Is Automation the Answer in Auditing?

Ask Kathy Pride, and she’ll tell you: there are two ways for healthcare providers to perform proactive auditing of their claims. There’s the old way—and there’s the better way. The […]

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What’s on Your 2021 OIG Compliance Greatest Hits List?

Compliance plans are critical to making sure your organization is mitigating risk. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recommends that you audit […]

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New ICD-10 Codes Create Clarity in Capturing COVID in 2021

The chaos and confusion fomented throughout the American healthcare industry by the continuing COVID-19 pandemic has been bad enough in of itself – but when coders found themselves unable to […]

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Three Key Takeaways from the FY 2021 Inpatient Prospective Payment System Proposed Rule

Typically, we would have the Final Rule updates to the Inpatient Prospective Payment System (IPPS) for the 2021 fiscal year (FY) 60 days prior to its effective date. However, this year, […]

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Five Key Takeaways from the CY 2021 Outpatient Prospective Payment System Proposed Rule

On August 4, the Centers for Medicare & Medicaid Services (CMS) released the Changes to Hospital Outpatient Prospective Payment System (OPPS) for the 2021 calendar year (CY). The proposed regulations […]

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What Radiology Practices Need to Know About Medicare’s Prior-Authorization Requirements

Beginning July 1,2020  Medicare required prior authorization for five procedure classes: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation. As a reminder, prior authorization was announced through the Calendar […]

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Relaxing Rules for Telehealth

I’m sure everyone has heard the saying, “the only constant is change.” Well, it certainly rings true these days. The Centers for Medicare & Medicaid Services (CMS) issued a second interim final […]