Healthicity Blog

The U.S. Health and Human Services Office of Inspector General (OIG) said it best: “An ongoing evaluation process is critical to a successful compliance program.” With 2023 halfway over, it’s a great time to pause and reflect on your compliance program’s wins and areas of opportunity for the...

The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently shared a new toolkit designed to help providers identify telehealth claims that could be at risk of fraud, waste or abuse.

Back to school season means a lot of things – summer is winding down, kids and teachers are heading back to the classroom, but for Carl, it means one thing: new pens and notebooks.

Modifier 59 is here, there, and everywhere!

It’s one of the most frequently used and misused modifiers in medical coding and billing, and it indicates that a procedure or service was distinct or independent from other services performed on the same day by the same provider.

A fundamental tenet of healthcare billing compliance is that services must be medically necessary.

“Think like a lawyer, talk like a human, and start with your audience."

Depending on who you ask, between 10% and 30% of claims are denied, lost, or ignored annually. That’s quite a chunk of change.

In June 2023, the U.S. Department of Health and Human Services Office of Inspector General (OIG) added many more items to their work plan. Let’s take a look at some that may be particularly important for compliance professionals in the health care industry.