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Provider’s Condensed Resource for Revenue Cycle, Coding Tools, and More

Author: Clack, Crystal; Freeman, Rae; Lewis, Laquette

Source: AHIMA practice brief | Journal of AHIMA

Publication Date: January 2017


A cyclone of regulatory requirements for providers has officially touched down in the United States. The Affordable Care Act (ACA), Medicare Access and CHIP Reauthorization Act (MACRA), patient-centered medical home (PCMH), and value-based purchasing (VBP) initiatives are contributing to dramat....

ABNs--Always Been Neglected

Author: Dunn, Rose T

Source: AHIMA community resource

Publication Date: November 14, 2003


For something that has been around for nearly 2 decades and supported by regulation since 1965, Advance Beneficiary Notices (ABNs) continue to cause headaches today. The use of written notices has been available since the enactment of PL 92-603 in 1972. The specific format called an Advance B....

Hot Spots in the 2002 OIG Work Plan

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: March 2002


Organizational compliance programs are never static. Rather, they must continually be refined and updated to respond to changes in healthcare delivery and system vulnerabilities. The 2002 Work Plan of the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) pr....

Unlock the Information Secrets in Your Billing Database

Author: Kuehn, Lynn

Source: AHIMA Convention

Publication Date: October 10, 2001




The data contained in your billing database can provide valuable information about billing accuracy and completeness, can identify coding trends that may require investigation, or provide information on patients who may require follow-up care. The billing database for a physician, or....

Choosing Consultants Without Compromising Compliance

Author: Hammen, Cheryl

Source: Journal of AHIMA

Publication Date: October 2001




Auditing coding and DRG accuracy has become an important component in the daily operation of the HIM department. Many providers are choosing to contract with external coding consultants to perform this task. This can be an appropriate solution as long as the vendor meets the necessary....

Preparing the Physician Office for HIPAA

Author: Uppena, Mary

Source: Journal of AHIMA - Coding Notes

Publication Date: February 2001




Change has been a constant factor in coding and reimbursement with the intensified focus on billing, compliance, and cost control. Out of necessity, coding professionals in physician settings have learned to be organized, adaptable, and armed with the latest information. The mandates....

Journal Q&A (11/00)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: November 02, 2000

Q: Where can I find a medical record audit tool for physician practices?
A: Older versions of the HEDIS indicators contained a medical record audit tool that was used by many third-party payers with which physician groups contracted to provide medical care. If you have an old copy of HEDI....

Limitation on certain physician referrals

Author:

Source: U.S. Code

Publication Date: January 23, 2000

From the U.S. Code Online via GPO Access [wais.access.gpo.gov] [Laws in effect as of January 23, 2000] [Document not affected by Public Laws enacted between January 23, 2000 and December 4, 2001] [CITE: 42USC1395nn] TITLE 42--THE PUBLIC HEALTH AND WELFARE CHAPTER 7--SOCIAL SECURITY SUBCHAPTER XVIII....

Physician Office Billing Compliance Program

Author: Eisenhauer, Sue

Source: Journal of AHIMA

Publication Date: October 1997


Physician offices try to adhere to the coding and billing guidelines as defined by Medicare. However, claims to commercial insurance carriers frequently are not handled as precisely. The passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) has brought to our atte....