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OCR Releases a New Version of Guide to Privacy and Security of Electronic...

The Office of Civil Rights recently released Version 2.0 of its' Guide to Privacy and Security of Electronic Health Information ("Guide"). This new version of the Guide provides updated information...

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OIG Releases New Compliance Oversight Document for Health Care Governing Boards

On April 20th, Daniel R. Levinson, the Inspector General for the Office of Inspector General ("OIG"), U.S. Department of Health and Human Services ("HHS") delivered an address at HCCA's 19th Annual...

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Understanding MS-DRG Grouping under ICD-10

Now that ICD-10 is in full swing, we are seeing a lot of activity with providers, payers, consultants and regulators who need to understand how Acute Inpatient and Long Term Care Hospital claims...

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Supporting Compliance in the New World of Remote and Outsourced Coding &...

According to a recent HIM Benchmark Report, HIM department managers equally ranked Coder Productivity, Quality, and Managing Financial Metrics as their biggest challenges, while that same report noted...

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Be Prepared for Changes in Billing Discarded Drugs/ Biologicals

By Christina Panos, RHIA, CTROriginal post on 6/9/2016 updated on 6/10/2016 to reflect announced delay.The Centers for Medicare and Medicaid Services (CMS) has maintained a long-standing policy that...

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Keeping up with MS-DRG Revisions

CMS has issued two errata and correction notices for how MS-DRG logic functions in FY2017. These changes may impact payment. This article highlights a few examples.It is important to note that CMS...

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Understanding non-covered codes – help for denials management and pre-payment...

Wouldn't it be great if there was just ONE LIST of procedure codes published somewhere by Medicare to identify non-covered services? Unfortunately, there isn’t one, but a quick review of the...

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How health care economics teams communicate with payers (and other healthcare...

In January 2017, the FDA released draft guidance specifying the nature of communications between manufacturers and payers: The first draft guidance, entitled “Drug and Device Manufacturer...

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Claims Adjudication and Payer Rules under ICD-10

Because we process thousands of LCDs updates weekly for our Coding Suite, we often get some insights that we can share. With the implementation of ICD-10, a significant drop off in the number of local...

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Shared Services – Truth In Billing

By Jana Weis, Principal, Gill Compliance Solutions, LLC.As consultants in the healthcare industry, we are asked all kinds of questions on a daily basis.  Yet, if I were to add up the number of times...

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