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Word is Collaboration: How HIM, Revenue: Cycle, and Compliance Team Up for Success

Author: McDavid, Jan P; Truscott, Tricia; Crump, Dawn; Brocato, Lori

Source: AHIMA Convention

Publication Date: October 02, 2011

Background:

The need for HIM, Compliance and Revenue Cycle Management to work together is more important than ever. New initiatives, regulations and more stringent compliance demands are crossing the lines of various departments throughout the healthcare continuum. Departments which may....

HIPAA Changes Call for Revising BA Agreements

Author: McDavid, Jan P

Source: Journal of AHIMA

Publication Date: May 2013



Business associates (BAs) of HIPAA-covered entities like hospitals and doctor's offices should already be intimately acquainted with HIPAA's privacy and security regulations. BAs should already have business associate agreements with every covered entity with whom they work and assume resp....

RAC Primer for LTC Facilities

Author: Leonard, Mary Ann

Source: Journal of AHIMA

Publication Date: January 2010



Last year the Centers for Medicare and Medicaid Services (CMS) began rolling out the Recovery Audit Contractor (RAC) program to all 50 states and all providers, including long-term care facilities. HIM professionals working in LTC facilities need to understand the basics of the program in....

Re-examining HIPAA Six Years Later

Author: Kloss, Linda L

Source: Journal of AHIMA

Publication Date: April 2008


It was six years ago this month that the HIPAA privacy rule went into effect. For many in healthcare, compliance has become a routine part of doing business. But for too many, the current regulations remain poorly understood and poorly implemented. All the while, the environment has been chang....

Fraud Management: a $100 Billion Bonus from Health IT?

Author: Kloss, Linda L

Source: Journal of AHIMA

Publication Date: March 2006


The financial losses from healthcare fraud in the US are staggering...and growing. Fraud was estimated to be between 3 and 10 percent of total health expenditures in 2003, or $51 to $170 billion, according to the National Health Care Anti-Fraud Association. Whether an interconnected health IT....

In Pursuit of Healthcare Fraud

Author: King, Ellen

Source: Journal of AHIMA

Publication Date: January 1999


How broad is the scope of healthcare fraud and abuse? Here's a look at the many ways the Federal Bureau of Investigation is tackling the problem.

Healthcare fraud takes billions of dollars away from federally funded healthcare programs. These programs, particularly Medicare and Med....

Benchmarks as the Signposts Along the Fraud Case Trail

Author: Kaldal, Karen

Source: Journal of AHIMA

Publication Date: November 1998


Traditionally, payers in the healthcare industry have relied on external tips or complaints for starting points for fraud investigations. But recently the number of leads on fraud activity has increased as the public becomes more aware of the issue. To combat this problem, payers have begun to....

RAC Ready: How to Prepare for the Recovery Audit Contractor Program

Author: Johnson, Kathy M; Bloom, Allison; Morris, Denise; Madamba, Roderick

Source: Journal of AHIMA

Publication Date: February 2009


The Centers for Medicare and Medicaid Services is expected to announce the official start date of the Recovery Audit Contractor program this month, but it is already time for providers to be preparing for a potential audit. Managing a RAC audit effectively and efficiently requires preparing de....

First Step Toward Compliance: OCR Outreach

Author: Jeffries, Jane

Source: Journal of AHIMA

Publication Date: February 2002


Though the Office for Civil Rights (OCR) has played an active role in the Department of Health and Human Services (HHS) since the early 1980s, it has only recently moved to the forefront of HIM professionals’ minds. Charged with enforcing the HIPAA privacy rule, OCR has become the leading....

Oral Privacy and HIPAA: We Really Need to Talk

Author: Jacobs, Jodi

Source: In Confidence (newsletter)

Publication Date: June 02, 2003


Oral privacy is not a new need or requirement in healthcare. However, because it is now backed by a federal mandate, it is receiving newfound attention. With the passing of the April 14, 2003, deadline for HIPAA compliance, hospitals, pharmacies, clearinghouses, physician’s offices, military....

Countdown to Compliance: Privacy

Author: Ingram-Muhammad, Sybil

Source: Journal of AHIMA

Publication Date: February 2002


How far along the road to compliance with the HIPAA privacy regulation is your organization? This article tells you the steps you should be taking to get in compliance by the April 2003 deadline.

It is February 2002—14 months before your organization has to be compliant with th....

HIPAA: It's Different for Manufacturers

Author: Humphrey, Heather L.

Source: Journal of AHIMA

Publication Date: February 2005


A few years ago, the Y2K crisis refocused the data world. Suddenly medical device manufacturers saw the inherent risks data brought to the business industry. What began with answering a simple question about date functionality quickly moved to conversations about personal information, its appr....

H&P Requirements Become More Uniform

Author: Hughes, Gwen

Source: Journal of AHIMA

Publication Date: May 2002


Until recently, the Medicare Conditions of Participation required that histories and physicals (H&Ps) be performed no more than seven days prior to hospital admission. This particular requirement was much stricter than the Joint Commission’s, which allows H&Ps to be performed as m....

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