October 15, 2016 marked 40 years since the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) was launched in 1976. It is now the largest inspector general with 1,600 employees and 70 offices and oversees $1 trillion in spending. The HHS OIG is charged with fighting fraud, waste and abuse in federal health care programs—primarily Medicare … [Read more...] about OIG celebrates 40 years of fighting fraud
Billing & collections
How to deliver a great presentation on any topic
To grow in the job, a manager has to communicate ideas and visions and recommendations. And the presentation of them counts. "It doesn't matter how good the idea or how brilliant the insight," if it isn't well articulated, it fails, says Patricia Fripp, CSP, CPAE, a San Francisco executive speech coach. Worse, the manager's career can fail right along with it. Here are the … [Read more...] about How to deliver a great presentation on any topic
Staff work as a financial team and increase the up-front payments
With all its staff – front desk, billing, and clinical – working as a financial team, a North Little Rock, AR, surgery practice has increased its pre-surgery payments by 25 percent. “It’s not rocket science,” says Linda Atkins, manager of Neurological Surgery Associates. “It’s just common-sense things.” Every staffer “looks at the money picture” and has a role in it, she says, … [Read more...] about Staff work as a financial team and increase the up-front payments
$900 million in false billing results in charges against medical practices throughout the U.S.
Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell have announced an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses, and other licensed medical professionals, for their … [Read more...] about $900 million in false billing results in charges against medical practices throughout the U.S.
Industry challenged to create more patient-friendly medical billing
Furthering the goals of focusing on patients, coordinate health care delivery, and making health information more accessible, the U.S. Department of Health and Human Services (HHS) has launched a new challenge for all stakeholders in health care—designing a better medical bill that is easier for patients to understand. The HHS press release regarding the challenge notes … [Read more...] about Industry challenged to create more patient-friendly medical billing
Incorrect medical coding corrupts the core data used by health care facilities, has negative consequences throughout health care industry
Guaranteeing accurate, consistent medical codes and patient histories is one of the major challenges for providers and payers today. Medical codes are the starting point for understanding quality of care and making necessary improvements. "Medical codes are the core data used in every aspect of modern health care—every provider, payer, and facility relies on them," says … [Read more...] about Incorrect medical coding corrupts the core data used by health care facilities, has negative consequences throughout health care industry
How to keep the cash coming in
When the office is busy but the cash flow is slow and the work isn't translating into net income for the physicians, look first to the billing and collections work. Almost always, that's where the failing lies. To keep the cash flowing, the office has to keep constant tabs on those two operations. Yet most offices don't. They just wait until they run out of cash. Here is how … [Read more...] about How to keep the cash coming in
Increased adoption of HIPAA electronic claims-related processes can save more than $8 billion annually
The U.S. health care system is unnecessarily spending billions of dollars each year by continuing to use manual administrative processes for basic transactions, according to the 2015 CAQH Index®, a report from CAQH, a non-profit alliance and leader in creating shared initiatives to streamline the business of health care. Despite steady increases in industry adoption of … [Read more...] about Increased adoption of HIPAA electronic claims-related processes can save more than $8 billion annually
You can’t do it all
By Steve M. Cohen bio I've been asked, even criticized, about focusing too much on the "soft" side of management. I'm asked why I don't discuss more "concrete" issues like medical billing software or the latest Medicare requirements. One answer is that these are not my areas of expertise. But the most important answer for you is that these are not the really … [Read more...] about You can’t do it all
Research assesses health care costs and utilization
The Health Care Cost Institute (HCCI), which promotes independent, nonpartisan research and analysis on the causes of the rise in U.S. health spending, has released a set of six policy briefs assessing the impact of a range of national and state policies on health care costs and utilization. The briefs were developed by independent researchers using HCCI's repository of … [Read more...] about Research assesses health care costs and utilization