You cannot simply gather staff into a room and say, “Here is your new software.” A successful implementation and training project requires a phased roll-out, well-defined team roles, and ongoing follow-up. Veteran healthcare at home IS consultant Darcey Trescone offers detailed guidelines based on years of experience with both successful and painful software implementations.
Your software vendor search is over. Your preferred servers, routers and operating systems have been selected. It was a grueling process but, now that it is over, you can relax, maybe give your IT department a half day off. According to a newly unveiled White Paper from Informatics Corporation of America, you had better not.
Some healthcare providers are concerned they may not know how to proceed if their organization is audited by a Recovery Audit Contractor (RAC) and receives a payment recoupment notice. Fortunately, there is a way to learn the RAC appeal process in advance and be completely prepared.
Now is a good time to determine your hospice’s level of risk exposure to overpayment recoupment from your RAC. Although the RACs have not kicked in yet and may not for several more months, conducting an assessment now can give you a better sense of how vulnerable your hospice might be and how much you […]
Since the inception of Medicare Fraud Strike Force operations in March 2007, the Strike Force has obtained indictments of more than 460 individuals and organizations that collectively have falsely billed the Medicare program for more than one billion dollars. In addition to the fraud hotbeds in Los Angeles, Houston, Detroit and — the one that […]
Attorney General Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius recently announced the creation of a new interagency effort, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), to combat Medicare fraud. Holder and Sebelius also announced the expansion of Strike Force team operations to Detroit and Houston. Medicare Fraud Strike Forces, […]
Health care fraud enforcement has restored funds to the trust funds and protected our citizens from health care fraud schemes. The Department is committed to the ongoing success of the HCFAC program and will continue to marshal its resources, including those provided by the HCFAC program and its own discretionary funds, to ensure that federal health care dollars are properly expended. We are committed to prosecuting fraud and abuse in the Medicare and Medicaid programs and restoring the recovered proceeds to these programs. We look forward to working with Congress and this Committee in particular, through these efforts, to make health care available to those who have no such safety net.
by Trisha Tulloch, RN, BSN, MSN, HCS-D In the summer of 2008, we at RBC Limited were privileged to work with two home health demonstration agencies participating with the Centers for Medicare and Medicaid Services (CMS) and Abt Associates to field test the revised OASIS-C. Since that time we have supported dozens of agencies in […]
“Clear as M.U.D.” presents actual stories of payment denials that appear on the surface to be difficult to explain. Fiscal Intermediaries and QICs are supposed to deny or recoup payments when a service to a patient appears to be a Medically Unbelievable Claim. On occasion, this can result in what we call a Medically Unbelievable […]
It is becoming apparent that certain cities have been targeted by recently stepped-up CMS efforts to protect the Medicare trust fund from inadvertent or fraudulent overpayments. Wise administrators and owners in non-targeted regions are watching what is going on in Miami, Houston and Los Angeles carefully, learning from the experiences of their colleagues there. Here […]
