Healthicity Blog

Risk analysis is the cornerstone of HIPAA compliance because it allows providers to safeguard against vulnerabilities to prevent data breaches or other serious security events. Performing risk analysis provides better security for patient health data.

In order to thoroughly scrutinize an audit, it’s important to understand who requested the audit, why they requested it, and what will be audited in the first place.

Every healthcare organization is faced with the challenge of improving their auditing efforts to meet compliance requirements. Arming yourself with the right information can vastly improve the way your organization approaches Evaluation & Management Audits (E/M) audits.

Tuomey, a community-based hospital in South Carolina, and the US government, recently resolved a False Claims Act judgement that resulted in a whopping $72 million dollar settlement.

It all started in 2005 when a physician at Tuomey decided to blow the whistle.

There can be a lot of ambiguity in E/M coding. Let’s get to the bottom of common problem areas in exam, history, using time to bill, and medical decision-making (MDM), to address misconceptions and answer some important questions related to some of these abstruse topics.

You’ve probably noticed that physicians may experience some confusion regarding the terms “medical necessity” and “medical decision making,” when coding E/M services.

Having an effective compliance program is absolutely crucial but measuring the success of any compliance program can be difficult. Available measures of success are not always industry-specific.

You’ve read about the risks of improper E/M coding, you’ve been warned about unbundling, and and how to tackle common auditing challenges but you might be surprised to learn that all risks aren’t a result of inaccurate coding.