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New Tool Streamlines HIPAA Assessment Process

Author: Cohen, Kathleen

Source: In Confidence (newsletter)

Publication Date: August 02, 2003


How are you making sure that your organization is complying with the HIPAA privacy regulations? Many hospitals are doing HIPAA rounds with privacy officers, going from unit to unit to assess and document HIPAA compliance. But trying to make sense of the data collected during HIPAA rounds can....

Medical Necessity under OPPS: a Look at the Challenges

Author: Carter, Darren

Source: Journal of AHIMA

Publication Date: February 2002


The outpatient prospective payment system (OPPS) has dramatically changed claims processing by introducing an automated system. Medical necessity validation has also been automated as a result, leaving hospitals with increased rejections. This article explores how OPPS impacts the medical nece....

Observation Services - Ensuring Every Dollar

Author: Canter, Kelly

Source: AHIMA Convention

Publication Date: October 02, 2011

Introduction

Inpatient medical necessity has become a very hot topic for the Recovery Audit Contractors (RACs) over the last 12 months. Due to the focus on medical necessity for inpatient admissions, proactive and reactive hospitals are scrutinizing their admission practices. Since there....

Leading the HIPAA Privacy Risk Assessment

Author: Callahan-Dennis, Jill

Source: AHIMA Convention

Publication Date: October 10, 2001




Introduction and Background

As part of their preparations for compliance with the Health Insurance Portability and Accountability Act (HIPAA), healthcare organizations need to compare their current information-handling and information-disclosure practices to the requirement....

HIPAA Breach Enforcement Roundup

Author: Cacciatore, Victoria; Downing, Katherine

Source: Journal of AHIMA

Publication Date: July 2014



Criminal attacks on healthcare systems have risen 100 percent since 2010, according to a recent Ponemon study.1 This makes it obvious that the privacy and security of patient health information is vulnerable and highly susceptible to data breach. The HIPAA Breach Notification Rule became e....

Coping with Government Audits

Author: Butler, Mary

Source: Journal of AHIMA - website

Publication Date: August 2014





The HIM Problem: Medicare Auditor Scrutiny of Inpatient Claims


This spring, the Centers for Medicare and Medicaid Services (CMS) issued its “two midnight rule” which was intended to define and clarify what Medicare considers to be criteria justifying an inpatient st....

On the Line: Professional Practice Solutions

Author: Burrington-Brown, Jill

Source: Journal of AHIMA

Publication Date: January 2002


Q: A couple were on vacation in my city when the husband suddenly became ill and died in our facility. The wife requested copies of the record to take home with her. She had listed herself as next of kin. Was it correct to give her a copy of the record?

Q: I am a manager of several d....

Catching Up with PEPP

Author: Bryant, Gloryanne H.; Fletcher, Robin

Source: Journal of AHIMA

Publication Date: September 2000


A year ago, the Journal of AHIMA reported on the newly created Payment Error Prevention Program (PEPP), which went into effect in August 1999. What has happened since then?
Best Billing Practices

PEPP was created to reduce Medicare prospective payment system (PPS) ....

CMS Bans Use of Physician Signature Stamps

Author: Bryant, Gloryanne H.

Source: Journal of AHIMA

Publication Date: November 2008


Question: What is the new Centers for Medicare and Medicaid Services ruling on use of signature stamps?

Answer: The Centers for Medicare and Medicaid Services (CMS) has made it clear that it will only accept signatures that are handwritten, electronic, or facsimiles of original wri....

Compliance Efforts Get Some PEPP

Author: Bryant, Gloryanne H.

Source: Journal of AHIMA

Publication Date: September 1999


Earlier this year, the Office of the Inspector General (OIG) informed the Health Care Financing Administration (HCFA) that "the DRG system is vulnerable to abuse by providers who wish to increase reimbursement inappropriately through upcoding, particularly so within certain DRGs.&....

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