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The recent $14.1 million False Claims Act settlement against Complete Health Partners Holdings, a management services organization operating provider groups in Florida, Alabama, and Colorado, brings to light the role coders can play in False Claims Act cases. In this instance, it was alleged that C…

When the Doctor Crossed the Line

Like the virtual line between actors and the audience, an invisible line exists between doctors and patients. Yet, Dr. Juliet B. Ugarte Hopkins will explore the sharp contrast in how pediatric and adult medicine address patient pain and fear. Reflecting on her own career choices and a lifelong need…
Tuesday, July 28 marks the 700th live edition of the commemorative Talk Ten Tuesdays broadcast. And in honor of this celebration, the ICD10monitor producers of the popular news and information service have invited Dennis Jones, the assistant vice president of revenue cycle for Jefferson Health, to …
Utilization managers (UMs) have long served as a resource for clinicians determining the appropriate patient status. Key considerations include which clinicians are involved, how communication occurs, and how status orders are entered. Because these processes can vary widely, it is essential to und…
The squeeze is on.Federal enforcement is intensifying, with behavioral health agencies facing heightened scrutiny following revealing reports from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). According to the OIG, there have been numerous fraud cases inv…
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