Corporate Compliance

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Using Critical Thinking to create the patient plan of care.

The worst disservice a clinician can do their patient and employer is not to use critical thinking when developing, implementing, revising the patient's Plan of Care, see "Using "Critical Thinking" during clinical practice..."

Up-date to ICD-10!

Changes to ICD-10 for 2018-2019 from the CDC!

Encouraging Physicians to Properly Complete Face to Face Encounters

Physicians may find themselves being denied payment by CMS for Case Management overseen fees and office visits due to poor documentation in their patient\\\'s medical record.

CMS Moratorium Extended!

CMS Moratorium extended! in the following geographical areas...

Tips

Acute-Care and Post-Acute Care Outcomes

What are the common Outcomes between Acute-Care and Post-Acute Care Organizations?

PEPPER Report

Problems getting your Pepper Report...

The Language of ICD-10

You are going to need to re-wire your brain!

Documentation

A Skilled Nursing Visit ...Clinical Vignet: 85 yrs old male admitted on 06/19/2015 at BBB Hospital for 4 days. Discharge home on 06/22/2015 with a stage II pressure ulcer on left heel and co-morbidity of Diabetes, Hypertension and Left CVA, patient is o

Do you have a Corporate Compliance Plan?

If you don't, is in your organization's best interest to have one. The following documents were developed by the OIG to provide guidance to organizations that would like to, voluntarily develop a compliance plan.

Is better to be proactive than reactive and have a Corporate Compliance Plan in place, especially when you are dealing with a Federal funded program. In 2009 the federal government put in a place The Health Care Fraud Prevention and Enforcement Action Team (HEAT) Task Force. This task force is composed of multi-federal and state programs as the Department of Health, Department of Justice, FBI and other state organizations. HEAT's Task Force mission is to help prevent waste, fraud, and abuse in the Medicare and Medicaid programs, crack down on the people and organizations who abuse the system and cost Americans billions of dollars each year, reduce health care costs and improve quality of care by preventing fraudsters from preying on people with Medicare and Medicaid, highlight best practices by providers and organizations dedicated to ending waste, fraud, and abuse in Medicare and build upon the existing partnerships between HHS and DOJ to reduce fraud and recover taxpayer dollars.

According to the HEAT's Medicare Fraud Strike Force, they have charged more than 1,400 defendants who collectively falsely billed the Medicare program more than $4.8 billion since 2007 and in 2011 HEAT coordinated the largest-ever federal health care fraud takedown involving $530 million in fraudulent billing.