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Compliance is Everybody’s Business: Clinical, Revenue Cycle, IT, Sales and Marketing

YouCompli

Sharon Parsley, JD, MBA, CHC, CHRC contributes a monthly post on compliance officer effectiveness for the YouCompli blog. Many people in our discipline love the slogan “compliance is everybody’s business.” For me, that has sometimes been the Chief Medical Officer or a physician CEO who really understood what I was trying to do.

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2024 Final Rule: CMS Announces More Changes to Medicare Advantage but Declines to Reform the “60 Day Rule”

Health Care Law Brief

MA plans will be required to have a Utilization Management Committee that conducts annual reviews of policies to ensure compliance with the foregoing. Notable Omissions from Proposed Rule CMS declined to adopt previously proposed amendments to the standard for “identified overpayments” under Medicare Parts A, B, C, and D. See 42 U.S.C.

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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. If the payer, such as Medicare, performs an extrapolation, reducing each overpayment dollar through appeal can mean thousands less to pay back.

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