How to Avoid False Claims Related to Medical Necessity
Nowadays, rarely does a week go by without the Department of Justice announcing another settlement related to allegations of a lack of medical necessity resulting in false claims....
Revenue Cycle Management Compliance: Ensuring Financial Health in Healthcare
Revenue Cycle Management (RCM) is the financial process utilized by healthcare providers to manage the administrative and clinical functions associated with claims processing,...
July 16, 2024
Uncovering $9 Million in Unbilled Services
Mock audits deliver value for healthcare Mock audits are an incredible tool for compliance officers to protect a healthcare organization’s revenue and add tangible value. They...
July 12, 2023
Healthcare Compliance Risks with Urine Drug Testing Overpayments
A physician practice in Texas paid $3.9 million. A major health system in California paid $13 million. A solo practitioner in Washington state paid $228,000. A physicians group in...
March 22, 2023
Compliance Risks Associated with Outlier Payments
Leverage OIG reports to protect healthcare revenue. Raising prices on your hospital’s chargemaster can also raise your level of compliance grief. In fact, some enforcement...
February 22, 2023
Healthcare Compliance is Everybody’s Business: Clinical, Revenue Cycle, IT, Sales and Marketing
Build relationships with key clinical and operational areas Sharon Parsley, JD, MBA, CHC, CHRC contributes a monthly post on compliance officer effectiveness for the YouCompli...
December 14, 2022
Critical Care Services Under the Microscope
Compliant Billing for Critical Care Evaluation and Management Services CJ Wolf, MD provides enforcement action summaries for the YouCompli blog. These summaries provide...
November 9, 2022
A million-dollar healthcare compliance monitoring mistake
Don’t let processes overwhelm clinical colleagues Helping our clinical colleagues feel the urgency of compliance monitoring can be a huge challenge. They’re busy seeing patients...
October 26, 2022
Physician Coding and Billing Enforcement: What to Watch For
CJ Wolf, MD writes enforcement action summaries for the YouCompli blog. These summaries provide real-world examples of regulators’ response to practices that don’t fully comply...
May 11, 2022
Beneficiary inducements…don’t cross that line
CJ Wolf, MD provides enforcement action summaries for the YouCompli blog. These summaries provide real-world examples of regulators’ response to practices that don’t fully comply...
April 13, 2022