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Red Flag Rules in Healthcare: What Compliance Officers Need to Know

Compliancy Group

For example, some medical identity thieves take insurance information and make fraudulent claims to Medicare or Medicaid for services or goods. Identity theft can also result in the entry of false data into electronic medical records (EMRs) or the creation of fictitious EMRs in victims names.

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Important Resources to Ensure Medicare Compliance

Compliancy Group

As a compliance officer or critical decision-maker, you can help your healthcare organization avoid exclusion from this valuable program by creating a comprehensive compliance program and using software to streamline your compliance processes. Office of Inspector General (OIG) guidelines.

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Webinar Recap: Elevate Your Referring and Ordering Physician Monitoring

Provider Trust

Continuous compliance begins with automated monitoring, cross-departmental communication, and population-specific workflow. In a recent webinar , ProviderTrust Founder Michael Rosen and Chief Compliance Officer Donna Thiel detailed ways in which your organization can effectively monitor your unique provider populations.

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Part 3: Audit Documentation to Avoid Potential Appeal Consequences

AIHC

Providers may take documentation “short cuts” or feel overwhelmed with implementation of a new EMR (electronic medical record) system and clone or make documentation errors. Evidence of Medical Necessity Medical necessity includes frequency, duration, previous conservative treatment (that failed) and other factors.

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