Medical Billing Blog: Section - Audit

Archive of all Articles in the Audit Section

This is the archive containing links to all articles written in the Audit section of our blog.

Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.

MIPS: The Day of Reckoning

One of my favorite books is The Big Short by Michael Lewis. It was eventually made into a movie by the same name and gives a clear view of the housing bubble that burst 10 years ago and pushed the US economy into the Great Recession. What fascinates me was the ability of some to predict, and profit, from knowing when the collapse would occur. They were able to delve into the details of millions of mortgages and see when the adjustable rates would suddenly increase leading to escalating mortgage payments and boosting the default rates dramatically. The subsequent collapse was unavoidable, and predictable. What does this have to do

Published By: Melissa Clark, CCS-P, RT | No Comments

Are Biometrics the Future of HIPAA Security?

Medical electronic health records, or EHRs for short, may have the potential to be much more secure than conventional records. That sounds like a bold claim in light of news about data breaches involving personal information. In fact, according to a report from the Identity Theft Resource Center and CyberScout, the number of tracked data breaches in the United States in 2016 hit an all-time high of 1,093. And still, more than 78% of doctors use EHRs, says the CDC. For medical professionals and the healthcare industry as a whole, keeping sensitive data secure and adhering to HIPAA regulations is a top priority. After all, EHRs can include years of

Published By: Melissa Clark, CCS-P, RT | No Comments

The Latest Details on HIPAA Compliance Audits

Deven McGraw, deputy director of the Department of Health and Human Services’ Office for Civil Rights has announced that the department’s plans for initiating onsite audits is currently on hold and will remain so until more than 200 desk audits have been completed. An article over on Data Breach Today gives us great detail on where HIPAA compliance audits stand with their enforcing agency. McGraw informed the HIMSS17 conference in February of the delay. We have decided that it makes a lot more sense to [first] take a look at all we had in the desk audit process and even prepare the overarching report to the public about how those

Published By: Melissa Clark, CCS-P, RT | No Comments

Demonstrating the Complexity of Care

SCENARIO: So, you are working at a multi-specialty practice that recently employed a urologist. As the Lead Medical Auditor and a member of the Corporate Compliance Team, you begin to worry about the chart audits as you have no members on your team that have worked within this specialty before. Take a deep breath – and remember that the largest volume of claims that the urologist will bill are E&M services. Regardless of the specialty of any medical practice, each will utilize Evaluation and Management (E&M) services in greater volumes than surgical services. Specialty-specific trained medical auditors are well versed in trudging through records to note the disease processes and

Published By: Shannon DeConda | No Comments

Deadlines: Regulations on HIPAA Compliance for Physicians

The deadline of September 23, 2013 has come and gone on the calendar. It was on this day the federal government enacted changes to the Health Insurance Portability and Accountability Act, better known as HIPAA. Medical physicians must be compliant with privacy and security and changes will include things like how to properly secure a patient’s health information or what you must tell a patient about their privacy rights. Medical physicians have 6 months to comply, and for many this is a difficult task to stay on so that the deadline is met. Compliance of the act includes the following updates to the regulations. Physicians must conduct a risk analysis

Published By: Melissa Clark, CCS-P, RT | No Comments

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