Volunteer Work

Posted on Leave a comment

“What is the essence of life?  To serve others and to do good.”  Aristotle Why is Volunteer Work Good for Us? With our busy lives, it can be difficult to find time to volunteer.  We all know that doing volunteer work benefits those that are in need, but did you know that volunteer work is […]

Teamwork

Posted on Leave a comment

“Great things in business are never done by one person, they’re done by a team of people.”  Steve Jobs What is teamwork? The business dictionary defines teamwork as a process of working collaboratively with a group of people in order to achieve a goal.  Teamwork is essential to accomplishing the objectives and goals of an organization.  […]

Vendor Partners

Posted on Leave a comment

Are your vendors also your business partners? While having customers/clients is vital to your business or practice, vendor partner relationships play an important role in efficiency and how smoothly your company or practice operates.  Therefore, having the right vendor partners can make it easier for you to succeed and grow your business or practice. A […]

Pre-authorization

Posted on Leave a comment

What is pre-authorization and why is it important?  Pre-authorization is the insurance company’s permission that is given to the provider to perform a service.  If permission is not obtained, the provider will not properly get paid for the service.  The prior approval process allows the insurance company to (1) verify that the patient’s account has […]

Clean Claims

Posted on Leave a comment

What is a clean claim?  A clean claim is a claim that was accurately processed and paid the first time it was submitted to the insurance payer; it is the ultimate goal in medical billing. Why do you want clean claims? When a claim is rejected, it delays your payment, inflates your accounts receivable, and […]

Should You Have a Compliance Hotline?

Posted on Leave a comment

Do you provide a Compliance Hotline to your employees, vendors, patients and their families?  One of the seven elements of an effective compliance plan is the development of effective lines of communication.  As a provider, your staff, patients, and family members of your patients need to feel that they have the freedom, as well as […]

Supervision Rules in Radiology

Posted on Leave a comment

Diagnostic tests paid under the Medicare Physician Fee Schedule (MPFS) for the physician office and the Outpatient Prospective Payment System (OPPS) for hospital outpatient departments are regulated by the Centers for Medicare & Medicaid Services (CMS) by way of its supervision rules.  A supervising physician provides oversight of the medical (technical) components of the facility.  […]

The Seven Elements of an Effective Compliance Plan

Posted on Leave a comment

As a healthcare provider, do you have a compliance plan in place?  Healthcare providers and business associates are required by law to have a compliance program.  And as a part of the program, we are mandated to have a compliance plan.  Unfortunately, there is not a “one-size- fits-all” template that providers are able to adopt.  […]

Medicare Fraud & Abuse

Posted on Leave a comment

How does Medicare define fraud?  It is when you knowingly submit or cause to be submitted false claims or making misrepresentations of facts to obtain a payment from the federal government, which you are not entitled to.  It is also when you knowingly solicit, receive, offer, and/or paying remuneration to induce or reward referrals for […]