False Claims Act Penalties are Rising
A recent increase in false claims penalties and a Supreme Court case placing the burden on healthcare organizations to be aware of payment requirements, necessitates that hospital compliance officers redouble efforts to prevent false claims.
Winning Direct Contracts with Employers
Pacific Business Group on Health, a leader in direct contracting, uses an extensive evaluation process to choose the provider organizations for its Employers Centers of Excellence Network.
Hospitals with PBGH Joint Replacement Contracts
Pacific Business Group on Health (PBGH), a membership organization that includes many of America’s largest healthcare purchasers, has developed direct contracts for joint replacements, spine procedures, and bariatric surgery with hospitals across the country.
New HIPAA Audits About to Begin
Both desk and on-site HIPAA audits will be performed, and every covered healthcare entity and business associate is eligible for an audit.
Interstate Compact Eases Licensure, Improves Quality of Care
Currently, 17 states have adopted compacts to help physician specialists practice across state lines, opening the door for telemedicine opportunities.
States Adopting Interstate Medical Licensure Compacts
Certain states are removing barriers to telemedicine by making it easier for physicians to practice across state lines.
How Emory Clinic Uses Game-Based Principles to Boost Productivity
Leaders at Emory Clinic use gamification techniques to improve revenue cycle staff performance. In three months, A/R staff increased their productivity by 7.9 percent, trimmed six days from net days in A/R, and increased net payments by 6.2 percent.
When Leading and Managing Others: First Do No Harm
A five step model helps leaders focus on the potential ethical issues behind their decisions.
When Patients Decline To Buy Exchange Coverage
Three revenue cycle leaders explain how their organizations extend financial assistance to patients who decline to obtain coverage from an insurance exchange, even though they are eligible to do so.
Raising Red Flags for Coder Quality in ICD-10
By analyzing coder performance data, organizations pinpoint revenue vulnerabilities and mitigate reimbursement risk.