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Author : Bill Dacey
Publisher : Delmar
ISBN 13 :
Total Pages : 278 pages
Book Rating : 4.:/5 ( download)
Download or read book The Physician Compliance Auditing and Monitoring Manual written by Bill Dacey and published by Delmar. This book was released on 2001 with total page 278 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Ingenix, Inc. Staff
Publisher :
ISBN 13 : 9781563297502
Total Pages : 260 pages
Book Rating : 4.2/5 (975 download)
Download or read book Physician Compliance Auditing and Monitoring Guide written by Ingenix, Inc. Staff and published by . This book was released on 2001-11 with total page 260 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Margret Amatayakul
Publisher : HC Pro, Inc.
ISBN 13 : 9781578393589
Total Pages : 238 pages
Book Rating : 4.3/5 (935 download)
Download or read book Guide to HIPAA Auditing written by Margret Amatayakul and published by HC Pro, Inc.. This book was released on 2004 with total page 238 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Ingenix, Incorporated
Publisher :
ISBN 13 : 9781563299179
Total Pages : pages
Book Rating : 4.2/5 (991 download)
Download or read book Physician Compliance Auditing and Monitoring written by Ingenix, Incorporated and published by . This book was released on 2002-11 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : HCPro
Publisher : HC Pro, Inc.
ISBN 13 : 1601460767
Total Pages : 278 pages
Book Rating : 4.6/5 (14 download)
Download or read book Hospital Auditing and Monitoring Toolkit written by HCPro and published by HC Pro, Inc.. This book was released on 2007-09 with total page 278 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :
Publisher :
ISBN 13 : 9781733598750
Total Pages : pages
Book Rating : 4.5/5 (987 download)
Download or read book Complete Healthcare Compliance Manual 2021 written by and published by . This book was released on 2021-04 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Wolters Kluwer and the American Health Law Association
Publisher : Aspen Publishers
ISBN 13 : 9781543822892
Total Pages : 1654 pages
Book Rating : 4.8/5 (228 download)
Download or read book Health Care Compliance Professional's Manual written by Wolters Kluwer and the American Health Law Association and published by Aspen Publishers. This book was released on 2020-03-10 with total page 1654 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Health Care Compliance Professional's Manual is one of the most vital, long-standing, and best known resources in the world of health care compliance. It has all the tools you and your compliance team need to plan and execute a customized compliance program. This new edition is filled with industry best practices, sample forms, policies, procedures, and much more to save you time and comply with federal standards. The Health Care Compliance Professional's Manual will help you to: Use OIG publications and Federal Sentencing Guidelines to plan and execute a customized compliance strategy that meets tough federal standards and minimizes enforcement risks Oversee physician compensation and referrals Perform risk assessments using matrixes with step-by-step instructions to pinpoint areas that pose compliance and operational risks Draft compliance policies that form the foundation for a strong compliance program Build a strong infrastructure reinforced by industry best practices Create an effective education and training program that instills in employees the importance of legal compliance Implement a privacy and security plan that ensures patient information is protected Stay up-to-date on the latest legal and state and federal regulatory requirements affecting your facility, in areas such as HIPAA, EMTALA, fraud and abuse, reimbursement, privacy, security, patient safety, and clinical research Study for CCB(R) Certification in Healthcare Compliance (CHC) Packed with tools to make your job easier and more efficient, The Health Care Compliance Professional's Manual will provide: Practical coverage of federal and state laws governing your facility Insight into helpful federal standards on effective compliance programs Step-by-step guidance on implementing a sound compliance program Examples of common risk areas and how to handle them Time savings and peace of mind from sample policies, checklists and forms from members of the American Health Law Association (AHLA) The Health Care Compliance Professional's Manual will help you protect your company if violations do occur: Learn how to apply auditing, monitoring, and self-assessment techniques for conducting internal investigations Discover how to successfully follow the OIG's voluntary disclosure program to resolve overpayment problems and avoid exclusion from Medicare Find out how to enter into a corporate integrity agreement to settle with the federal government and mitigate FCA-related penalties Document your compliance efforts so you leave a protective paper trail that shields you from liability And much more Previous Edition: Health Care Compliance Professional's Manual, Second Edition ISBN: 9781543813265 SKU: 10071961-7777
Author : Bill Dacey
Publisher : Delmar
ISBN 13 :
Total Pages : 368 pages
Book Rating : 4.:/5 ( download)
Download or read book Physician Compliance Implementation Manual written by Bill Dacey and published by Delmar. This book was released on 2001 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Richard P. Kusserow
Publisher : Hcpro, a Division of Simplify Compliance
ISBN 13 : 9781601461728
Total Pages : 0 pages
Book Rating : 4.4/5 (617 download)
Download or read book The Healthcare Compliance Professional's Guide to Policies and Procedures written by Richard P. Kusserow and published by Hcpro, a Division of Simplify Compliance. This book was released on 2008 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ready-made compliance policies and procedures that you can adapt to your facility. Policies and procedures are the backbone of any compliance program. Compliance professionals must ensure that their policies and procedures are effective and up to date. To ensure effectiveness, the OIG expects hospitals to regularly re-evaluate their policies and procedures. Insight from a former Inspector General The Healthcare Compliance Professional's Guide to Policies and Procedures is written by former Inspector General Richard P. Kusserow. He has filled this book with sample policies and procedures that hospitals can use to strengthen their existing compliance program or help build a new one. Customize your program immediately The Healthcare Compliance Professional's Guide to Policies and Procedures provides the easy-to-use policies and procedures you need to ensure that your compliance program runs efficiently and smoothly. With these tools you will be able to: Implement proven, effective policies and procedures by using the sample templates provided Instruct staff with easy-to-comprehend instructions regarding policy and procedure development Identify best practices for policy and procedure development that are most likely to pass OIG investigation Ensure your policies are up to date with all legislation passed through the beginning of 2008 All of these sample policies and procedures can be used right away. Download our sample policies directly from the companion CD-ROM. You can then customize each document to fit your specific situation. It's that easy to develop a proven, effective set of policies and procedures! Take a look at the table of contents to see the variety of sample policies and procedures you will receive with The Healthcare Compliance Professional's Guide to Policies and Procedures: Compliance program oversight policies and procedures Compliance officer duties and responsibilities Confidentiality agreements Compliance officer and legal counsel protocol Records management Standards of conduct Ethics Compliance education and training Billing and coding policies Accurate coding Observation status Accurate documentation Prohibition of fraudulent and abusive billing Medicare's "incident to" rule Charity/uninsured care Medical necessity How to check for medical necessity ABN use for items and services that do not meet medical necessity Conflicts of interest agreements Gifts Vendor relationships Discounts/professional courtesies Reporting compliance problems Hotline use Hotline auditing Responses to complaints Nonretaliation policy (whistleblower protection) Auditing and monitoring Procedures for documenting auditing and monitoring Standards for auditing and monitoring Policies specific to laws and regulations Stark Anti-kickback statute False Claims Act Deficit Reduction Act EMTALA HIPAA Other risk areas Quality of care Clinical trials
Author : Margret Amatayakul
Publisher :
ISBN 13 : 9781615692835
Total Pages : 0 pages
Book Rating : 4.6/5 (928 download)
Download or read book Guide to Hipaa Auditing, Third Edition written by Margret Amatayakul and published by . This book was released on 2014-08-12 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Guide to HIPAA Auditing: Practical Tools for Privacy and Security Compliance, Third Edition Margret Amatayakul, MBA, RHIA, CHPS, CPHIT, CPEHR, CPHIE, FHIMSS What you don't know about HIPAA can hurt you! Workforce turnover, new information systems, and external forces are continuous compliance challenges. A 138% increase in the number of privacy and security breaches affecting 500 or more individuals between 2012 and 2013, plus HIPAA Omnibus Rule requirements, make a workable HIPAA compliance plan, adequate resources, and tools to help you determine your current compliance status more critical than ever. With HIPAA audits slated to resume and Office for Civil Rights (OCR) monetary settlements steadily increasing, the risk of ending up on OCR's "wall of shame" is greater than ever. OCR and two covered entities recently entered into the largest HIPAA settlement to date--a combined $4.8 million penalty for alleged violations during a joint arrangement. The first step to ensuring HIPAA compliance is developing an effective risk analysis and management process that identifies threats, corrects vulnerabilities, and protects your patients. The Guide to HIPAA Auditing: Practical Tools for Privacy and Security Compliance, Third Edition, will help you build a successful HIPAA compliance auditing and monitoring program at your organization. It will help you identify potential risks, improve your compliance program, and document your activities--putting you in good standing for any government audit or litigation that requires you to substantiate your efforts. This book will help you do the following: Build the business case for compliance assurance Understand and communicate to all concerned, including your workforce and business associates, the purpose and nature of auditing and monitoring for privacy and security compliance Develop an appropriately resourced privacy and security compliance assurance program Use tools to effectively plan for, conduct, and document the process of auditing and monitoring privacy and security compliance Close the feedback loop when potential issues arise and necessitate privacy and security compliance assurance improvements Identify and evaluate external resources for constructing your privacy and security compliance assurance program TABLE OF CONTENTS: Chapter 1: Building the Business Case for Compliance Assurance Chapter 2: Compliance Assurance Program Chapter 3: Organizational Relationships Chapter 4: Audit Planning Chapter 5: Auditing Uses and Disclosures Chapter 6: Auditing Individual Rights Chapter 7: Auditing Risk Analysis Chapter 8: Auditing Privacy and Security Administrative Requirements Chapter 9: Auditing Physical Security Chapter 10: Auditing Technical Security Chapter 11: Auditing Breach Notification Compliance Chapter 12: Education, Training, and Awareness Appendix WHO SHOULD READ THIS BOOK: Privacy officers Information security officers Compliance officers Risk officers HIM directors and managers IT security staff
Author : Joe Rivet
Publisher : Hcpro, a Division of Simplify Compliance
ISBN 13 : 9781601468215
Total Pages : 0 pages
Book Rating : 4.4/5 (682 download)
Download or read book Auditing Evaluation and Management Services, Second Edition written by Joe Rivet and published by Hcpro, a Division of Simplify Compliance. This book was released on 2011-06-15 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Auditing Evaluation and Management Services: A Step-By-Step Guide to Accurate Coding, Reimbursement and Compliance, Second Edition Joe Rivet, CCS-P, CPC, CEMC, CPMA, CICA, CHRC, CHC Turn E/M audits into informative reports that minimize your compliance risk The government is increasing its scrutiny of physician E/M coding. Conducting your own E/M coding audits is best practice to effectively: Analyze complex code assignment options to select the appropriate code Assign an appropriate E/M code based on documentation in the record Identify opportunities for increased revenue and ways to reduce compliance risks Understand the rules and regulations that apply to E/M services billed to Medicare Auditing Evaluation and Management Services is an essential tool to ensure audit success and E/M compliance. This second edition goes beyond the fundamentals of E/M coding and delves into the gray, problematic compliance areas. Author Joe Rivet delivers step-by-step guidance from beginning to end of the E/M audit process. You'll learn how to Select an E/M code, Conduct an entire audit of your E/M services Report your E/M audit findings With this foundation, you'll be well prepared to enhance compliance and identify undercoding, underreporting, overcoding, revenue opportunities, and avenues for documentation improvement. Auditing Evaluation and Management Services, Second Edition, will help practices enhance existing auditing programs by explaining how to determine accurate E/M error rates and assess risk. You will learn how to: Determine proper E/M code selection Conduct risk assessments Structure audits, using the provided E/M audit tool, and package audits Create provider audit summary reports, practice audit summary reports, missed revenue reports, and an action plan Follow guidelines for facility E/M services and interpret the rules governing E/M services involving residents or fellows (including acceptable and unacceptable documentation) Develop a compliance plan and educate a variety of audiences from physicians to coding staff Take a look at the table of contents E/M Code Categories NEW! Selecting an E/M Code Conducting a Risk Assessment E/M Audit Structure Using an Audit Tool Packaging an Audit Facility E/M Services NEW! Teaching Physician Services NEW! Developing a Compliance Plan Education Techniques NEW! What's new? New chapters devoted to: E/M Code Categories Facility E/M Services Teaching Physicians Education Techniques Who will benefit from this book? Auditors and compliance officers in physician practices and hospitals Health systems that own physician practices Business managers Office managers Practice administrators Coding, billing, and reimbursement managers and staff Earn continuing education credits American Academy of Professional Coders This program has prior approval of the American Academy of Professional Coders (AAPC) for 3 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the Academy of the program, content, or the program sponsor. American Health Information Management Association This program has been approved for 4 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).
Author : Rebecca S. Busch
Publisher : John Wiley & Sons
ISBN 13 : 0470399465
Total Pages : 256 pages
Book Rating : 4.4/5 (73 download)
Download or read book Electronic Health Records written by Rebecca S. Busch and published by John Wiley & Sons. This book was released on 2008-12-15 with total page 256 pages. Available in PDF, EPUB and Kindle. Book excerpt: Electronic Health Records: An Audit and Internal Control Guide describes the infrastructure of electronic health records and the impact that the government's new criteria will have on the private and public marketplace. Understand what to look for in a health care record management system and find tips and helpful guidance for implementation. If you are trying to facilitate an audit of a health record management system, you can apply the example described in the model, which will serve as a timely model and invaluable resource.
Author : John Steiner, Jr.
Publisher :
ISBN 13 : 9780979221019
Total Pages : pages
Book Rating : 4.2/5 (21 download)
Download or read book Monitoring and Auditing Practices for Effective Compliance written by John Steiner, Jr. and published by . This book was released on 2002-01-01 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This book was prepared to assist compliance officers and compliance committee members with designing and maintaining an effective corporate compliance program by providing an in-depth look at monitoring and auditing strategies and tactics.
Author : OECD
Publisher : OECD Publishing
ISBN 13 : 9264805907
Total Pages : 447 pages
Book Rating : 4.2/5 (648 download)
Download or read book Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Author : Clay Countryman
Publisher : Aspen Pub
ISBN 13 : 9780834218703
Total Pages : 500 pages
Book Rating : 4.2/5 (187 download)
Download or read book Physician Practice Compliance Resource Manual written by Clay Countryman and published by Aspen Pub. This book was released on 2001 with total page 500 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Physician Practice Compliance Resource Manual is a comprehensive, practical resource designed specifically for the medical group practice environment. This manual will not only review the legislation governing compliance issues in group practices, it will provide practical instruction and tools for implementing a physician practice compliance program, as well as sample forms, policies and procedures to help practices get started. The material will include checklists to guide physicians in meeting Federal compliance guidelines; a suggested schedule and work plan for developing a compliance program; audit plans, including information on working with attorneys and consultants; sample discipline, waiver, billing and reporting policies, and much more. An indispensable resource, the manual will be updated annually.
Author : Gina M. Reese
Publisher : Hcpro, a Division of Simplify Compliance
ISBN 13 : 9781683081906
Total Pages : 0 pages
Book Rating : 4.0/5 (819 download)
Download or read book Provider-based Entities written by Gina M. Reese and published by Hcpro, a Division of Simplify Compliance. This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book serves as a comprehensive guide to provider-based clinics, from qualifying under CMS, to unique billing and coding rules, and the business decisions behind owning or acquiring these clinics. It will help readers sort through the complex regulations relevant to this unique provider type, and provide insight into recent changes, such as the introduction of Modifier -PO. CMS is looking to implement the Section 603 provisions of the Bipartisan Budget Act of 2015 regarding off-campus, provider-based departments (PBD) by January 1, 2017, according to the 2017 OPPS proposed rule. The agency is proposing to pay the nonfacility or office Medicare Physician Fee Schedule (MPFS) amount to the performing/supervising physician and preclude hospitals from billing on a UB-04 form or receiving OPPS payment for services performed at these locations for 2017, but plans to explore other options for 2018 and beyond. Physicians would be paid at the higher nonfacility rate of the MPFS, but only hospitals that have employed or contracted physicians that reassign their billing to the hospital would get paid under the MPFS for these services. Hospitals would be able to bill claims on CMS-1500 forms for physicians who have already reassigned their billing to the hospital, as in the case of employed physicians. Otherwise, hospitals would have the option of enrolling the location as the type of provider or supplier it wishes to bill to meet the requirements of that payment system (e.g., ambulatory surgery center or group practice).
Author : United States Government Accountability Office
Publisher : Lulu.com
ISBN 13 : 0359536395
Total Pages : 234 pages
Book Rating : 4.3/5 (595 download)
Download or read book Government Auditing Standards - 2018 Revision written by United States Government Accountability Office and published by Lulu.com. This book was released on 2019-03-24 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt: Audits provide essential accountability and transparency over government programs. Given the current challenges facing governments and their programs, the oversight provided through auditing is more critical than ever. Government auditing provides the objective analysis and information needed to make the decisions necessary to help create a better future. The professional standards presented in this 2018 revision of Government Auditing Standards (known as the Yellow Book) provide a framework for performing high-quality audit work with competence, integrity, objectivity, and independence to provide accountability and to help improve government operations and services. These standards, commonly referred to as generally accepted government auditing standards (GAGAS), provide the foundation for government auditors to lead by example in the areas of independence, transparency, accountability, and quality through the audit process. This revision contains major changes from, and supersedes, the 2011 revision.
