Medical Records

Posted on November 12, 2019

Recently, the medical records of hundreds of patients were trashed outside of a medical office building in New York City.  The records belonged to patients of two gastroenterologists.  The Protected Health Information (PHI) that were exposed included names and social security numbers of these patients.  The gastroenterologists were moving to a new nearby office.  They had left the patient charts at their old office to be retrieved by a shredding company.  They had placed the blame on their cleaning people for throwing the records out.  The doctors adamantly deny that they had improperly disposed the records.  They also said that they have “policies and procedures in place regarding the safeguarding and/or disposal of their patients’ protected health information.”  An effective policy and procedure could have prevented such a breach from happening. 

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Customer Service

Posted on October 9, 2019

“Happy customers are your biggest advocates and can become your most successful sales team.”

                                                                                                                                                                                   Lisa Masiello

What is Good Customer Service?

 Customer service is the entire experience (from initial contact to final sale and beyond), that a customer or potential customer may have with your company.  The experience can either be face-to-face, on a telephone call or online.  According to Salesforce, great customer service is: (1) service that is fast; (2) service that is personalized; (3) service that provides a connected experience; (4) service that is proactive (offering a resolution before an issue or disruption occurs).


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Volunteer Work

Posted on August 27, 2019

“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 good for us as well?  Volunteering can make us feel happier and healthier.  Here are some of benefits that we receive by giving.


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Posted on July 30, 2019

“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.  And the ability to perform both as an individual and as an effective teammate is the key to professional growth and success.

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Vendor Partners

Posted on June 26, 2019

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 vendor provides products and/or services to businesses/practices.  A vendor partnership goes beyond the scope of just their products and services.  When a partnership exists between your business/practice and the vendor, there is a cooperative effort to succeed together.  Vendor partners want you to succeed.  They do not just sell you a product and then walk away.  They continue to be responsive to your needs even after the sale.  It means that your phone calls and emails are returned in a timely manner.  Good vendor partners understand that communication is key to a successful relationship.  Vendor partners also respects your time, which means that scheduled meetings are on time and the necessary individuals are present on conference calls.  Your vendor partner should be experts in their field and can help you resolve any issues you run into.

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Posted on May 31, 2019

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 enough benefit dollars for the insurance company to pay the provider for that upcoming service; (2) ensure that the particular service is an eligible service under the patient’s insurance plan; (3) determine if the procedure is medically necessary.

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Clean Claims

Posted on May 2, 2019

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 increase your operational costs because the whole claim cycle must begin again.  Your staff or billing company will have to identify/review the denials and perform any necessary corrections, in order to resubmit these claims to the payers.  Thus, it is in your best interest to ensure that you have a high percentage of clean claims.

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Should You Have a Compliance Hotline?

Posted on April 1, 2019

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 the obligation, to report compliance issues, such as potential improper coding or billing practices, vendor misconduct, harassment, bullying, or other improper conduct.  Offering a compliance hotline gives the complainant the ability to report the issues anonymously, a solution for those who are in fear of retaliation.

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Supervision Rules in Radiology

Posted on March 12, 2019

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.  Duties include overseeing quality assurance, testing of equipment, development of protocols for the studies, creating policies and procedures that guide the medical operations of the organization, as well as the oversight of the healthcare staff.  The objective is to ensure study quality and patient safety.

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The Seven Elements of an Effective Compliance Plan

Posted on February 26, 2019

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.  Each organization is different, with different operational environments and ways of doing things.  Due to this uniqueness, it makes sense that each compliance plan would differ from one to another.

While the process of creating a compliance program can be daunting, having one is advantageous.  First, it is a proactive way to ensure that you are meeting the statutory and regulatory requirements.  Second, it shows the government your good faith effort to comply with the law should you ever become the subject of an investigation.  Along with that, should you ever become convicted for violations of any of these statutes and/or regulations, having a compliance plan is favorably considered at sentencing.

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