Healthicity Blog

In this episode of Compliance Conversations, I sat down with Senior Consultant, Brenden O’Neil, who works in Intermountain’s professional coding and reimbursement department. O’Neil and I had a fascinating discussion on CPT codes and the complicated gray area of coding a laminectomy.

Compliance officers don’t necessarily need to know everything about medical coding and modifiers, but at a minimum, compliance officers should know that modifiers matter.

1. Miami-Area Man Charged For Role in $63 Million Health Care Fraud Scheme - A Miami-area man was charged in an indictment unsealed today for his alleged participation in a $63 million health care fraud scheme involving a now-defunct community mental health center located in Miami. Read the full...

Compliance and coding are complicated.

1. Electronic Health Records Vendor To Pay The Largest Settlement In The District Of Vermont: eClinicalWorks LLC to Pay $155 Million to Resolve Civil False Claims Act Allegations –

We all “report up” to somebody at some point and that goes for the OIG, too, in their regular reports to Congress. Recently, the OIG submitted its Semiannual Report to Congress for the period of Oct. 1, 2016 to March 31, 2017.

Opinions aren’t always the most effective way to make a case. I’ve found that it’s always easier to find an existing citation or reference instead of using your opinion. Opinions simply sound too subjective and there are too many gray areas in compliance for subjectivity.

“What are the first steps I should take to improve my compliance program right now?”

To put it simply: The more you know, the better off you’ll be. A great compliance program starts with knowledge of compliance, rules and regulations, and best practices.